Has widespread use of biologic and immunosuppressant therapy for ulcerative colitis affected surgical trends? Results of a questionnaire survey of surgical institutions in Japan
Has widespread use of biologic and immunosuppressant therapy for ulcerative colitis affected surgical trends? Results of a questionnaire survey of surgical institutions in Japan
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DOI：
10.1007/s00595-015-1259-3
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发表时间：
2016-08-01
期刊：
影响因子：
2.5
通讯作者：
Ozawa, Heita
中科院分区：
文献类型：
--
作者：
Kimura, Hideaki;Takahashi, Kenichi;Ozawa, Heita
本研究的目的是评估生物和免疫抑制剂治疗的引入与溃疡性结肠炎（UC）手术患者数量之间的关系。对日本26家教学医院进行了关于UC手术患者的问卷调查。问卷调查时间跨度为2008年至2013年，以说明他克莫司（2009年）和英夫利西单抗（2010年）的引入。2008年、2009年、2010年、2011年、2012年和2013年接受手术的患者总数分别为297、291、273、255、300和305例。急诊手术率每年稳定在32- 34%。因癌症接受手术的患者比例从2008年的13. 8%上升到2013年的20%。2013年，41%、38%和6%接受手术的患者分别接受了生物制剂、他克莫司和环孢素治疗。没有机构报告使用免疫抑制药物治疗的患者术后并发症增加。在英夫利西单抗和他克莫司首次广泛使用后不久，接受手术的患者数量暂时减少，但随后再次增加。在整个研究期间，急诊手术率保持不变。这些数据表明，免疫抑制药物对术后并发症的风险几乎没有影响。
The aim of the study is to assess the relationship between the introduction of biologic and immunosuppressant therapy and the number of patients undergoing surgery for ulcerative colitis (UC).A questionnaire survey about patients undergoing surgery for UC was sent to 26 teaching hospitals throughout Japan. The questionnaire period spanned from 2008 to 2013, to account for the introduction of tacrolimus (2009) and infliximab (2010).The total number of patients who underwent surgery was 297, 291, 273, 255, 300, and 305 in 2008, 2009, 2010, 2011 2012, and 2013, respectively. The emergency surgery rate remained stable at 32-34 % each year. The proportion of patients who underwent surgery for cancer increased from 13.8 % in 2008 to 20 % in 2013. In 2013, 41, 38, and 6 % of patients who underwent surgery had received treatment with a biologic, tacrolimus, and cyclosporine, respectively. No institution reported an increase in postoperative complications among patients treated with immunosuppressive drugs.The number of patients undergoing surgery decreased temporarily soon after infliximab and tacrolimus first became widely available, but subsequently increased again. The emergency surgery rate remained unchanged throughout the study period. These data show that immunosuppressive drugs have had little effect on the risk of postoperative complications.