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择期乙状结肠切除术治疗憩室炎后,无复发是否意味着无症状?

After Elective Sigmoid Colectomy for Diverticulitis, Does Recurrence-Free Mean Symptom-Free?

作者信息

Choi Karmina K, Krautsak Kevin, Martinolich Jessica, Canete Jonathan J, Valerian Brian T, Chismark A David, Lee Edward C

出版信息

Am Surg. 2020 Jan 1;86(1):49-55.

Abstract

After elective sigmoidectomy for diverticulitis, patients may experience persistent abdominal symptoms. This study aimed to determine the incidence and characteristics of persistent symptoms (PSs) and their risk factors in patients who had no reported recurrence after elective sigmoidectomy. Patients who underwent elective sigmoidectomy for diverticulitis from 2002 to 2016 at a tertiary academic colorectal surgery practice were included. After retrospective review of medical records, patients were contacted with a questionnaire to inquire about recurrence of diverticulitis and persistent abdominal symptoms since resection. Outcomes examined were prevalence of and risk factors for PSs after elective sigmoidectomy. Of 662 included patients, 346 completed the questionnaire and had no recurrent diverticulitis. PSs were reported by 43.9 per cent of the patients. The mean follow-up was 87 months. Female gender and preoperative diagnosis of irritable bowel syndrome were independent risk factors for PSs (Relative Risk 1.65, 0.001 and Relative Risk 1.41, = 0.014). Previous IV antibiotics treatment was associated with PSs ( = 0.034) but not with a significant risk factor. As the follow-up interval increased, prevalence of PSs decreased ( = 0.006). More than 40 per cent of patients experienced persistent abdominal symptoms after sigmoidectomy for diverticulitis. Female patients and those with irritable bowel syndrome were at significantly increased risk.

摘要

在因憩室炎接受择期乙状结肠切除术后,患者可能会出现持续性腹部症状。本研究旨在确定在择期乙状结肠切除术后无复发报告的患者中持续性症状(PSs)的发生率、特征及其危险因素。纳入了2002年至2016年在一家三级学术性结直肠外科诊所因憩室炎接受择期乙状结肠切除术的患者。在对病历进行回顾性审查后,通过问卷调查联系患者,询问自切除术后憩室炎的复发情况和持续性腹部症状。研究的结果是择期乙状结肠切除术后PSs的患病率及其危险因素。在纳入的662例患者中,346例完成了问卷调查且无憩室炎复发。43.9%的患者报告有PSs。平均随访时间为87个月。女性性别和术前诊断为肠易激综合征是PSs的独立危险因素(相对风险分别为1.65,P = 0.001和相对风险1.41,P = 0.014)。既往静脉使用抗生素治疗与PSs有关(P = 0.034),但不是显著的危险因素。随着随访间隔时间的增加,PSs的患病率降低(P = 0.006)。超过40%的患者在因憩室炎行乙状结肠切除术后出现持续性腹部症状。女性患者和患有肠易激综合征的患者风险显著增加。

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