{"title":"微创经会阴腹会阴切除术治疗克罗恩病的临床效果：回顾性分析。","authors":"Yoshitaka Kondo, Nobuhiko Kanaya, Ryohei Shoji, Toshihiro Inokuchi, Sakiko Hiraoka, Yusuke Yoshida, Yuki Matsumi, Kunitoshi Shigeyasu, Fuminori Teraishi, Shinji Kuroda, Toshiyoshi Fujiwara","doi":"10.1111/ases.70149","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Crohn's disease (CD) often leads to complex anorectal complications, posing significant challenges in surgical management. Transperineal abdominoperineal resection (TpAPR) has emerged as a minimally invasive alternative to APR. This study aims to evaluate the safety and efficacy of TpAPR compared to APR in patients with CD.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A retrospective analysis was conducted on 19 CD patients who underwent either minimally invasive TpAPR (<i>n</i> = 11) or APR (<i>n</i> = 8) between 2008 and 2023 from a single institution. The primary outcomes were assessed: intraoperative blood loss, operative time, and surgical site infection (SSI) rates.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The minimally invasive TpAPR group exhibited significantly reduced intraoperative blood loss (223 mL vs. 533 mL, <i>p</i> = 0.04) and a lower incidence of SSI rates (36.4% vs. 75%, <i>p</i> = 0.07). Operative time and hospital stay were comparable between groups.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Minimally invasive TpAPR demonstrates potential benefits over APR in reducing blood loss and SSI rates in CD patients. Further large-scale studies are warranted to confirm these findings.</p>\n </section>\n </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70149","citationCount":"0","resultStr":"{\"title\":\"Clinical Impacts of Minimally Invasive Transperineal Abdominoperineal Resection in Crohn's Disease: A Retrospective Analysis\",\"authors\":\"Yoshitaka Kondo, Nobuhiko Kanaya, Ryohei Shoji, Toshihiro Inokuchi, Sakiko Hiraoka, Yusuke Yoshida, Yuki Matsumi, Kunitoshi Shigeyasu, Fuminori Teraishi, Shinji Kuroda, Toshiyoshi Fujiwara\",\"doi\":\"10.1111/ases.70149\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Crohn's disease (CD) often leads to complex anorectal complications, posing significant challenges in surgical management. Transperineal abdominoperineal resection (TpAPR) has emerged as a minimally invasive alternative to APR. This study aims to evaluate the safety and efficacy of TpAPR compared to APR in patients with CD.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A retrospective analysis was conducted on 19 CD patients who underwent either minimally invasive TpAPR (<i>n</i> = 11) or APR (<i>n</i> = 8) between 2008 and 2023 from a single institution. The primary outcomes were assessed: intraoperative blood loss, operative time, and surgical site infection (SSI) rates.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The minimally invasive TpAPR group exhibited significantly reduced intraoperative blood loss (223 mL vs. 533 mL, <i>p</i> = 0.04) and a lower incidence of SSI rates (36.4% vs. 75%, <i>p</i> = 0.07). Operative time and hospital stay were comparable between groups.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Minimally invasive TpAPR demonstrates potential benefits over APR in reducing blood loss and SSI rates in CD patients. Further large-scale studies are warranted to confirm these findings.</p>\\n </section>\\n </div>\",\"PeriodicalId\":47019,\"journal\":{\"name\":\"Asian Journal of Endoscopic Surgery\",\"volume\":\"18 1\",\"pages\":\"\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70149\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asian Journal of Endoscopic Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/ases.70149\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Journal of Endoscopic Surgery","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ases.70149","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
克罗恩病（CD）经常导致复杂的肛肠并发症，对手术治疗提出了重大挑战。经会阴腹会阴切除术（TpAPR）已成为一种可替代APR的微创手术。本研究旨在评估TpAPR与APR在CD患者中的安全性和有效性。方法：回顾性分析2008年至2023年间来自一家机构的19例CD患者，他们分别接受了微创TpAPR （n = 11）或APR （n = 8）。评估主要结局：术中出血量、手术时间和手术部位感染（SSI）率。结果：微创TpAPR组术中出血量明显减少（223 mL vs. 533 mL, p = 0.04）， SSI发生率明显降低（36.4% vs. 75%, p = 0.07）。两组间手术时间和住院时间具有可比性。结论：与APR相比，微创TpAPR在减少CD患者失血和SSI发生率方面具有潜在的优势。需要进一步的大规模研究来证实这些发现。
Clinical Impacts of Minimally Invasive Transperineal Abdominoperineal Resection in Crohn's Disease: A Retrospective Analysis
Introduction
Crohn's disease (CD) often leads to complex anorectal complications, posing significant challenges in surgical management. Transperineal abdominoperineal resection (TpAPR) has emerged as a minimally invasive alternative to APR. This study aims to evaluate the safety and efficacy of TpAPR compared to APR in patients with CD.
Methods
A retrospective analysis was conducted on 19 CD patients who underwent either minimally invasive TpAPR (n = 11) or APR (n = 8) between 2008 and 2023 from a single institution. The primary outcomes were assessed: intraoperative blood loss, operative time, and surgical site infection (SSI) rates.
Results
The minimally invasive TpAPR group exhibited significantly reduced intraoperative blood loss (223 mL vs. 533 mL, p = 0.04) and a lower incidence of SSI rates (36.4% vs. 75%, p = 0.07). Operative time and hospital stay were comparable between groups.
Conclusion
Minimally invasive TpAPR demonstrates potential benefits over APR in reducing blood loss and SSI rates in CD patients. Further large-scale studies are warranted to confirm these findings.
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