Influence of hysterectomy on fistula formation in women with diverticulitis
Influence of hysterectomy on fistula formation in women with diverticulitis
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DOI：
10.1002/bjs.6855
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发表时间：
2010-02-01
影响因子：
9.6
通讯作者：
Johansson, A. L. V.
中科院分区：
文献类型：
--
作者：
Altman, D.;Forsgren, C.;Johansson, A. L. V.
背景：憩室炎是瘘管形成的一个危险因素，但子宫切除术对瘘管形成的影响尚不清楚。一项以人群为基础的全国性匹配队列研究，以确定瘘形成的风险在子宫切除术的妇女，和没有，diverticulitis.Methods：妇女谁了子宫切除术1973年和2003年之间，和匹配的对照组，确定从瑞典住院登记。憩室炎和瘘管手术的发病率确定交叉链接到登记册，并使用考克斯回归model.Results的风险进行估计：在一个队列的168 563 adminorectomized和614 682 nonadminorectomized妇女（平均随访11.0和11.5年），有14 051例憩室炎和851瘘管。与既没有子宫切除术也没有憩室炎的妇女相比，在没有憩室炎的子宫切除术妇女中，瘘管手术的风险增加了4倍（风险比（HR）4.0（95%置信区间（c.i.）3.5结论：憩室炎和较小程度的子宫切除术与瘘管形成的风险密切相关。患有憩室炎的子宫切除术妇女发生手术治疗瘘管的风险最高。
Background: Diverticulitis is a risk factor for fistula formation but little is known about the influence of hysterectomy in this association. A population-based nationwide matched cohort study was performed to determine the risk of fistula formation in hysterectomized women with, and without, diverticulitis.Methods: Women who had a hysterectomy between 1973 and 2003, and a matched control cohort, were identified from the Swedish Inpatient Register. Incidence of diverticulitis and fistula surgery was determined by cross-linkage to the Register, and risk was estimated using a Cox regression model.Results: In a cohort of 168 563 hysterectomized and 614 682 non-hysterectomized women (mean follow-up 11.0 and 11.5 years respectively), there were 14 051 cases of diverticulitis and 851 fistulas. Compared with women who had neither hysterectomy nor diverticulitis, the risk of fistula surgery increased fourfold in hysterectomized women without diverticulitis (hazard ratio (HR) 4.0 (95 per cent confidence interval (c.i.) 3.5 to 4.7)), sevenfold in non-hysterectomized women with diverticulitis (HR 7.6 (4.8 to 12.1)) and 25-fold in hysterectomized women with diverticulitis (HR 25.2 (15.5 to 41.2)).Conclusion: Diverticulitis, and to a lesser extent hysterectomy, is strongly associated with the risk of fistula formation. Hysterectomized women with diverticulitis have the highest risk of developing surgically managed fistula.