A retrospective analysis of 20-year data of the surgical management of ulcerative colitis patients in Taiwan: a study of Taiwan Society of Inflammatory Bowel Disease.
A retrospective analysis of 20-year data of the surgical management of ulcerative colitis patients in Taiwan: a study of Taiwan Society of Inflammatory Bowel Disease.
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DOI：
10.5217/ir.2016.14.3.248
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发表时间：
2016-07
影响因子：
4.9
通讯作者：
Lin JK
中科院分区：
文献类型：
--
作者：
Lin CC;Wei SC;Lin BR;Tsai WS;Chen JS;Hsu TC;Lin WC;Huang TY;Chao TH;Lin HH;Wong JM;Lin JK
随着医学治疗的不断进步，外科手术在溃疡性结肠炎（UC）的治疗中仍然扮演着重要的角色。在这项研究中，我们通过与台湾IBD协会合作的多中心研究，分析了台湾近20年来UC的手术结果和结局。对1995年1月1日至2014年12月31日在台湾6家主要医疗中心进行的UC患者手术数据进行了回顾性分析。记录并分析患者的人口统计学数据、手术指征和结局详情。记录87例接受手术治疗的UC患者的数据。中位术后随访时间为51.1个月，范围为0.4 - 300个月。UC诊断时的平均年龄为45.3±16.0岁，手术时的平均年龄为48.5±15.2岁。手术干预的3个主要适应症为不受控制的出血（16.1%）、穿孔（13.8%）和顽固性（12.6%）。总的来说，27.6%的手术是在紧急情况下进行的。保留直肠的全结肠或次全结肠切除术（41.4%）是最常见的手术。有6例死亡，均由败血症引起。急诊手术和术前低白蛋白水平与不良生存率显著相关（分别为P=0.013和0.034）。过去20年来，UC患者的手术指征没有明显变化。急诊手术和术前低白蛋白水平与生存率低相关。因此，对于控制不佳的UC患者，选择最佳手术时机至关重要。
With the recent progress in medical treatment, surgery still plays a necessary and important role in treating ulcerative colitis (UC) patients. In this study, we analyzed the surgical results and outcomes of UC in Taiwan in the recent 20 years, via a multi-center study through the collaboration of Taiwan Society of IBD. A retrospective analysis of surgery data of UC patients from January 1, 1995, through December 31, 2014, in 6 Taiwan major medical centers was conducted. The patients' demographic data, indications for surgery, and outcome details were recorded and analyzed. The data of 87 UC patients who received surgical treatment were recorded. The median post-operative follow-up duration was 51.1 months and ranged from 0.4 to 300 months. The mean age at UC diagnosis was 45.3±16.0 years and that at operation was 48.5±15.2 years. The 3 leading indications for surgical intervention were uncontrolled bleeding (16.1%), perforation (13.8%), and intractability (12.6%). In total, 27.6% of surgeries were performed in an emergency setting. Total or subtotal colectomy with rectal preservation (41.4%) was the most common operation. There were 6 mortalities, all due to sepsis. Emergency operation and low pre-operative albumin level were significantly associated with poor survival (P=0.013 and 0.034, respectively). In the past 20 years, there was no significant change in the indications for surgery in UC patients. Emergency surgeries and low pre-operative albumin level were associated with poor survival. Therefore, an optimal timing of elective surgery for people with poorly controlled UC is paramount.