Atasoy Deniz, Aghayeva Afag, Bilgin İsmail Ahmet, Erzin Yusuf, Bayraktar İlknur Erenler, Baca Bilgi, Karahasanoğlu Tayfun, Hamzaoğlu İsmail
Department of General Surgery, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey.
Department of Gastroenterology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
Turk J Gastroenterol. 2018 Jul;29(4):406-410. doi: 10.5152/tjg.2018.17687.
BACKGROUND/AIMS: Most of the patients with Crohn's disease (CD) may require at least one surgical procedure over their lifetime. However, these patients tend to have a high incidence of postoperative complications. The aim of this retrospective study was to investigate the predictive parameters of postoperative complications in CD.
All consecutive patients with CD between March 2001 and March 2016 who underwent bowel resection were included to this study. Postoperative complications were divided as; major complications including anastomotic leakage, ostomy complications, acute mechanical intestinal obstruction and hemorrhage, and minor complications including wound infection.
A total of 147 patients (74 females, 73 males) with a mean age of 36±11.9 years met the inclusion criteria. Behaviors of CD were stricturing in 90 (62%), fistulizing in 45 (30%) and inflammatory in 12 (8%) patients. Minimally invasive approach was applied in 35% (n=51) of the patients. Twentysix (17%) patients had early (≤30 days) postoperative surgical complications including anastomotic leak (n=10), intra-abdominal bleeding (n=2), complications related to ostomy (n=2), acute mechanical intestinal obstruction (n=1) and wound infection (n=11). Only fistulizing disease behavior was associated with early postoperative complications (p=0.014).
This study suggests that postoperative complications are still more common in fistulizing CD. Surgical approach did not affect the complication rate. The decision should be individualized according to the prominent risk factors and surgeons' preference.
背景/目的:大多数克罗恩病(CD)患者在其一生中可能至少需要接受一次外科手术。然而,这些患者术后并发症的发生率往往较高。本回顾性研究的目的是探讨CD患者术后并发症的预测参数。
本研究纳入了2001年3月至2016年3月期间所有连续接受肠切除术的CD患者。术后并发症分为:主要并发症包括吻合口漏、造口并发症、急性机械性肠梗阻和出血,以及次要并发症包括伤口感染。
共有147例患者(74例女性,73例男性)符合纳入标准,平均年龄为36±11.9岁。CD的行为表现为狭窄型90例(62%)、瘘管型45例(30%)和炎症型12例(8%)。35%(n = 51)的患者采用了微创方法。26例(17%)患者术后早期(≤30天)出现手术并发症,包括吻合口漏(n = 10)、腹腔内出血(n = 2)、造口相关并发症(n = 2)、急性机械性肠梗阻(n = 1)和伤口感染(n = 11)。只有瘘管型疾病行为与术后早期并发症相关(p = 0.014)。
本研究表明,瘘管型CD患者术后并发症仍然更为常见。手术方式并未影响并发症发生率。应根据突出的危险因素和外科医生的偏好进行个体化决策。