Kim Duk Hwan, Cheon Jae Hee, Moon Chang Mo, Park Jae Jun, Han Song Yi, Kim Eun Soo, Chung Moon Jae, Lee Jin Ha, Jung Min Kyu, Lee Soo Hyun, Son Jung Woo, Kim Tae Il, Kim Won Ho
Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2009 Jan;53(1):29-35.
BACKGROUND/AIMS: This study was conducted to compare the clinical efficacy between surgical and nonsurgical treatments for patients with Crohn's disease-related intraabdominal abscess.
A retrospective review of medical records was performed for patients admitted to a single institution due to Crohn's disease-related intraabdominal abscess from February, 1996 to February, 2008. Clinical outcomes were compared between surgical and nonsurgical groups in terms of treatment responses and recurrences.
A total of 47 episodes of intraabdominal abscesses in 43 patients (12.7%) were identified from 339 patients with Crohn's disease. Of these, initially, 18 cases (38.3%) underwent surgical treatment and 29 (61.7%) were treated medically (antibiotic treatments with or without percutaneous drainage). The overall treatment response rates of surgical and nonsurgical group were 100% versus 89.7% (p=0.11) and recurrence rates were 27.8% versus 30.8% (p=1.00). Three patients in nonsurgical group (10.3%) showed no response to therapy and ultimately received surgical drainages. The median length of hospitalization in nonsurgical group was shorter than in surgical group (12 and 29.5 days, respectively. p=0.02).
Nonsurgical treatment might be as effective as surgical treatment for the treatment of Crohn's disease-related intraabdominal abscess, especially considering shorter hospital stay.
背景/目的:本研究旨在比较手术治疗与非手术治疗对克罗恩病相关性腹腔内脓肿患者的临床疗效。
对1996年2月至2008年2月因克罗恩病相关性腹腔内脓肿入住单一机构的患者病历进行回顾性分析。比较手术组和非手术组在治疗反应和复发方面的临床结局。
在339例克罗恩病患者中,共确诊43例患者(12.7%)发生47次腹腔内脓肿。其中,最初18例(38.3%)接受手术治疗,29例(61.7%)接受内科治疗(使用或不使用经皮引流的抗生素治疗)。手术组和非手术组的总体治疗反应率分别为100%和89.7%(p = 0.11),复发率分别为27.8%和30.8%(p = 1.00)。非手术组有3例患者(10.3%)对治疗无反应,最终接受了手术引流。非手术组的中位住院时间短于手术组(分别为12天和29.5天,p = 0.02)。
对于克罗恩病相关性腹腔内脓肿的治疗,非手术治疗可能与手术治疗同样有效,尤其是考虑到住院时间较短。