Ha Francis J, Thong Louisa, Khalil Hanan
Faculty of Medicine, Nursing and Health Sciences, Monash Rural Health, Joanna Briggs Centre, Monash University, Moe, VIC, Australia.
Dig Surg. 2017;34(5):355-363. doi: 10.1159/000453590. Epub 2017 Jan 19.
BACKGROUND/AIMS: Most patients with Crohn disease (CD) require surgery within 10 years of diagnosis. Intestinal resection is the most commonly performed operation although the effects on health-related quality of life (HRQOL), particularly long-term, are contentious.
We conducted a systematic review evaluating the impact of intestinal resection on the HRQOL of CD patients, predictors of postoperative HRQOL, and patient satisfaction with surgery.
Nine studies including 1,108 CD patients undergoing intestinal resection were identified as eligible for inclusion. The median age at surgery was 29-41 years with varying follow-up period (range 30 days-5 years). Ileocolic resection was the most commonly performed operation on an elective basis (range 95-100%). HRQOL improved as early as 2 weeks postoperatively and lasted up to 5 years across both generic and gastrointestinal domains. Gender, smoking, and disease recurrence were potential predictors of postoperative HRQOL. Patient satisfaction is high with regard to surgery, with preference for a laparoscopic approach.
Intestinal resection in CD patients improved HRQOL in the short- and long-term and patients describe high satisfaction about their surgery. Further studies are needed to validate potential predictors of postoperative HRQOL in this cohort.
背景/目的：大多数克罗恩病（CD）患者在确诊后10年内需要接受手术。肠切除术是最常进行的手术，尽管其对健康相关生活质量（HRQOL）的影响，尤其是长期影响，存在争议。
我们进行了一项系统评价，评估肠切除术对CD患者HRQOL的影响、术后HRQOL的预测因素以及患者对手术的满意度。
共纳入9项研究，包括1108例接受肠切除术的CD患者。手术时的中位年龄为29 - 41岁，随访期各不相同（范围为30天至5年）。回结肠切除术是最常择期进行的手术（范围为95% - 100%）。术后2周内HRQOL即有所改善，在一般领域和胃肠道领域可持续长达5年。性别、吸烟和疾病复发是术后HRQOL的潜在预测因素。患者对手术的满意度较高，更倾向于腹腔镜手术方式。
CD患者的肠切除术在短期和长期均改善了HRQOL，患者对手术的满意度较高。需要进一步研究以验证该队列中术后HRQOL的潜在预测因素。
