Siddiqui Ali A, Kedika Ramalinga, Mahgoub Amar, Patel Mahir, Cipher Daisha J, Bapat Vijay
Department of Internal Medicine, Dallas Veterans Affairs Medical Center, Dallas, TX 75216, USA.
South Med J. 2009 Nov;102(11):1111-5. doi: 10.1097/SMJ.0b013e3181b85063.
There is limited data assessing the relationship between cholecystectomy and colorectal adenomatous polyps (AP). Our aim was to determine if cholecystectomy was associated with an increased prevalence of advanced AP in male veterans.
The relationship of whether prior cholecystectomy modified the natural history of AP was investigated in a retrospective study. The patients were divided into two groups: 1) those with AP and a history of cholecystectomy, and 2) those with AP, but without a history of cholecystectomy. Factors in each group associated with advanced AP were examined by univariate analysis (UA) and stepwise logistic regression analysis to determine independent predictors of aggressive clinical characteristics of polyps. Statistical significance was determined at a P < or = 0.05.
We identified a total of 1234 patients with AP (cases = 127, controls = 1107). The mean age of patients was 64.1 +/- 1.9 (standard deviation) years. By UA, those with a prior cholecystectomy had a greater mean number of AP (4.2 vs. 3.5; P = 0.04) and more advanced polyps (P = 0.037) than those without a cholecystectomy. By logistic regression, prior cholecystectomy was associated with more advanced AP (OR = 1.5 [1.0-2.2]; P = 0.04). Patients who had a cholecystectomy were 51% more likely to have advanced AP. There appeared to be a trend towards increased time from cholecystectomy being associated with advanced polyps (9.69 years vs. 8.99 years, P = 0.056).
A prior cholecystectomy was independently associated with an increased risk of developing advanced AP. Also, there appeared to be a trend toward a greater prevalence of advanced lesions as postcholecystectomy time increased.
评估胆囊切除术与结直肠腺瘤性息肉（AP）之间关系的数据有限。我们的目的是确定胆囊切除术是否与男性退伍军人中晚期AP患病率增加有关。
在一项回顾性研究中，调查了既往胆囊切除术是否改变AP自然病史的关系。患者分为两组：1）有AP且有胆囊切除术史的患者，2）有AP但无胆囊切除术史的患者。通过单因素分析（UA）和逐步逻辑回归分析检查每组中与晚期AP相关的因素，以确定息肉侵袭性临床特征的独立预测因素。统计学显著性以P≤0.05确定。
我们共确定了1234例AP患者（病例=127例，对照=1107例）。患者的平均年龄为64.1±1.9（标准差）岁。通过UA，既往有胆囊切除术的患者AP的平均数量更多（4.2对3.5；P=0.04），息肉更晚期（P=0.037）。通过逻辑回归分析，既往胆囊切除术与更晚期的AP相关（OR=1.5[1.0-2.2]；P=0.04）。接受胆囊切除术的患者发生晚期AP的可能性高51%。胆囊切除术后时间延长与晚期息肉似乎有增加的趋势（9.69年对8.99年，P=0.056）。
既往胆囊切除术与发生晚期AP的风险增加独立相关。此外，随着胆囊切除术后时间的增加，晚期病变的患病率似乎有增加的趋势。
