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肠道白塞病患者初次肠道切除术后早期再次手术的结局及危险因素

The outcomes and risk factors of early reoperation after initial intestinal resective surgery in patients with intestinal Behçet's disease.

作者信息

Park Yong Eun, Cheon Jae Hee, Park Jihye, Lee Ji Hoon, Lee Hyun Jung, Park Soo Jung, Kim Tae Il, Kim Won Ho

机构信息

Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.

Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.

出版信息

Int J Colorectal Dis. 2017 Apr;32(4):591-594. doi: 10.1007/s00384-016-2743-y. Epub 2016 Dec 27.

Abstract

PURPOSE

Patients with intestinal Behçet's disease who underwent intestinal resective surgery often require reoperation. However, there have been no studies on the risk factors and outcomes of early reoperation in these patients.

METHODS

We retrospectively evaluated 41 patients with intestinal Behçet's disease who received repeated intestinal resective surgeries between 2006 and 2016. We analyzed two different patient groups-those who required early reoperation within 6 months and those who underwent reoperation >6 months after the initial surgery-and determined the risk factors for early reoperation.

RESULTS

Eleven patients (26.8%) underwent reoperation within 6 months and 30 patients (73.2%) after 6 months. Emergency surgery at the initial operation and higher initial perioperative erythrocyte sedimentation rate and C-reactive protein levels were significantly associated with early reoperation in the univariate analysis. After the multivariate analysis, initial emergency operation (P = 0.020; hazard ratio [HR], 42.625; 95% confidence interval [CI], 1.817-1000.088) and high erythrocyte sedimentation rate (P = 0.039; HR, 1.049; 95% CI, 1.002-1.097) were determined to be the independent factors for early reoperation.

CONCLUSIONS

Emergency surgery and high perioperative erythrocyte sedimentation rate levels were the prognostic factors for early reoperation (within 6 months) in patients with intestinal Behçet's disease after initial bowel resective surgery.

摘要

目的

接受肠道切除手术的肠道白塞病患者常需再次手术。然而,目前尚无关于这些患者早期再次手术的危险因素及预后的研究。

方法

我们回顾性评估了2006年至2016年间接受多次肠道切除手术的41例肠道白塞病患者。我们分析了两组不同的患者——在6个月内需要早期再次手术的患者和初次手术后6个月以上接受再次手术的患者——并确定了早期再次手术的危险因素。

结果

11例患者(26.8%)在6个月内接受了再次手术,30例患者(73.2%)在6个月后接受了再次手术。单因素分析显示,初次手术时的急诊手术以及较高的初次围手术期红细胞沉降率和C反应蛋白水平与早期再次手术显著相关。多因素分析后,确定初次急诊手术(P = 0.020;风险比[HR],42.625;95%置信区间[CI],1.817 - 1000.088)和高红细胞沉降率(P = 0.039;HR,1.049;95% CI,1.002 - 1.097)为早期再次手术的独立因素。

结论

急诊手术和围手术期高红细胞沉降率水平是肠道白塞病患者初次肠道切除手术后早期(6个月内)再次手术的预后因素。

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