Cammarota Teresa, Ribaldone Davide Giuseppe, Resegotti Andrea, Repici Alessandro, Danese Silvio, Fiorino Gionata, Sarno Antonino, Robotti Daniela, Debani Paola, Bonenti Giovanni, Pellicano Rinaldo, Andrealli Alida, Sapone Nicoletta, Simondi Daniele, Bresso Francesca, Astegiano Marco
Department of Radiology, Radiologia 5, AOU S. Giovanni Battista, Turin, Italy.
Scand J Gastroenterol. 2013 May;48(5):552-5. doi: 10.3109/00365521.2013.777774. Epub 2013 Mar 11.
In Crohn's disease natural history, about 80% of the patients require surgery, which is not curative: unfortunately, the disease recurs in many patients.
To investigate the role of intestinal ultrasound to predict the risk of post-operative surgical recurrence in Crohn's disease.
A total of 196 patients, with ileal or ileocolonic Crohn's disease, undergoing intestinal resection, were retrospectively enrolled. All patients underwent bowel ultrasonography 6-15 months after resection. Wall thickness at the anastomosis level was measured, and thickening >3 mm was evaluated as risk factor of long-term need for reoperation.
Patients who have a bowel wall thickness >3 mm have an risk ratio (RR) of surgical recurrence = 2.1 [95% confidence interval (CI) = 1.12-3.74] higher than those with a thickness of ≤3 mm. The absolute incidence of new surgical intervention is 13% in patients with thickness of 3 mm, 28% in patients with thickness >3 mm, 29,1% with thickness >4 mm, 34% with thickness >5 mm, and 40% with thickness >6 mm.
Bowel wall thickness >3 mm at ultrasound may be a non-invasive predictor of early surgical recurrence after ileo-colonic resection.
在克罗恩病的自然病程中，约80%的患者需要手术治疗，但手术无法治愈该病：不幸的是，许多患者疾病会复发。
探讨肠道超声在预测克罗恩病术后手术复发风险中的作用。
回顾性纳入196例接受肠道切除术的回肠或回结肠型克罗恩病患者。所有患者在切除术后6 - 15个月接受肠道超声检查。测量吻合口水平的肠壁厚度，肠壁增厚>3 mm被评估为长期需要再次手术的危险因素。
肠壁厚度>3 mm的患者手术复发风险比（RR）= 2.1 [95%置信区间（CI）= 1.12 - 3.74]，高于肠壁厚度≤3 mm的患者。肠壁厚度为3 mm的患者再次手术干预的绝对发生率为13%，厚度>3 mm的患者为28%，厚度>4 mm的患者为29.1%，厚度>5 mm的患者为34%，厚度>6 mm的患者为40%。
超声显示肠壁厚度>3 mm可能是回结肠切除术后早期手术复发的无创预测指标。
