Role of Extended Mesenteric Excision in Postoperative Recurrence of Crohn's Colitis: A Single-Center Study.
Role of Extended Mesenteric Excision in Postoperative Recurrence of Crohn's Colitis: A Single-Center Study.
复制标题
扩大肠系膜切除术在克罗恩病结肠炎术后复发中的作用：一项单中心研究
DOI：
10.14309/ctg.0000000000000407
复制
发表时间：
2021-10-01
影响因子：
3.6
通讯作者：
Zhu W
中科院分区：
文献类型：
--
作者：
Zhu Y;Qian W;Huang L;Xu Y;Guo Z;Cao L;Gong J;Coffey JC;Shen B;Li Y;Zhu W
简介：克罗恩病累及肠系膜。肠系膜切除范围对克罗恩病术后疾病进展的影响尚未得到证实。本研究旨在确定克罗恩氏结肠炎（CC）患者行结直肠手术时肠系膜切除与术后结局之间的关系。方法：对2000年1月至2018年12月期间接受结直肠切除术的CC患者进行了审查，数据来自前瞻性维护的数据库。根据肠系膜切除范围将患者分为广泛性肠系膜切除（EME）组和有限性肠系膜切除（LME）组。比较两组的术后早期发病率和手术复发率。结果：在纳入的126例患者中，LME组60例，EME组66例。除LME组术中失血量增加外（P = 0.002），两组术后早期结局无显著差异。与LME组相比，EME组患者术后无手术复发生存时间较长（P = 0.01）。LME是术后手术复发的独立预测因子（风险比2.67，95%置信区间1.04-6.85，P = 0.04）。这在接受结直肠切除和吻合术的患者的亚组分析中得到进一步证实（风险比2.83，95%置信区间1.01-7.96，P = 0.048）。讨论内容：在接受CC手术的患者中，与保留肠系膜时观察到的结果相比，包含肠系膜与相似的短期结局和改善的长期结局相关。
INTRODUCTION: The mesentery is involved in Crohn's disease. The impact of the extent of mesenteric resection on postoperative disease progression in Crohn's disease remains unconfirmed. This study aimed to determine the association between resection of the mesentery and postoperative outcomes in patients with Crohn's colitis (CC) undergoing colorectal surgery. METHODS: Patients with CC who underwent colorectal resection between January 2000 and December 2018 were reviewed, and the data were gathered from a prospectively maintained database. Patients were divided into 2 groups according to the extent of mesenteric resection, the extensive mesenteric excision (EME) group and the limited mesenteric excision (LME) group. Outcomes including early postoperative morbidities and surgical recurrence were compared between the 2 groups. RESULTS: Of the 126 patients included, 60 were in the LME group and 66 in the EME group. There was no significant difference between the 2 groups in early postsurgical outcomes except the intraoperative blood loss was increased in the LME group (P = 0.002). Patients in the EME group had a longer postoperative surgical recurrence-free survival time when compared with those in the LME group (P = 0.01). LME was an independent predictor of postoperative surgical recurrence (hazard ratio 2.67, 95% confidence interval 1.04–6.85, P = 0.04). This was further confirmed in the subgroup analysis of patients undergoing colorectal resection and anastomosis (hazard ratio 2.83, 95% confidence interval 1.01–7.96, P = 0.048). DISCUSSION: In patients undergoing surgery for CC, inclusion of the mesentery is associated with similar short-term outcomes and improved long-term outcomes compared with those seen when the mesentery is retained.
登录
查看更多内容
克罗恩病和溃疡性结肠炎表型的遗传决定因素：遗传关联研究。
DOI：
10.1016/s0140-6736(15)00465-1
发表时间：
2016-01-09
期刊：
Lancet (London, England)
影响因子：
--
作者：
Cleynen I;Boucher G;Jostins L;Schumm LP;Zeissig S;Ahmad T;Andersen V;Andrews JM;Annese V;Brand S;Brant SR;Cho JH;Daly MJ;Dubinsky M;Duerr RH;Ferguson LR;Franke A;Gearry RB;Goyette P;Hakonarson H;Halfvarson J;Hov JR;Huang H;Kennedy NA;Kupcinskas L;Lawrance IC;Lee JC;Satsangi J;Schreiber S;Théâtre E;van der Meulen-de Jong AE;Weersma RK;Wilson DC;International Inflammatory Bowel Disease Genetics Consortium;Parkes M;Vermeire S;Rioux JD;Mansfield J;Silverberg MS;Radford-Smith G;McGovern DP;Barrett JC;Lees CW
通讯作者：
Lees CW
影响因子：
29.4
作者：
COTTONE, M;ROSSELLI, M;PAGLIARO, L
通讯作者：
PAGLIARO, L
影响因子：
12.6
作者：
Burr, Nicholas E.;Lord, Richard;Subramanian, Venkataraman
通讯作者：
Subramanian, Venkataraman
影响因子：
6.3
作者：
Futami, K;Arima, S
通讯作者：
Arima, S
影响因子：
8
作者：
Bislenghi, G.;Ferrante, M.;D'Hoore, A.
通讯作者：
D'Hoore, A.