孕期克罗恩病的手术治疗：一项全国性调查。
Surgery for Crohn's disease during pregnancy: A nationwide survey.
作者信息
Germain Adeline, Chateau Thomas, Beyer-Berjot Laura, Zerbib Philippe, Lakkis Zaher, Amiot Aurélien, Buisson Anthony, Laharie David, Lefèvre Jérémie H, Nancey Stéphane, Stefanescu Carmen, Bresler Laurent, Peyrin-Biroulet Laurent
机构信息
Department of Digestive Surgery, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France.
Department of Hepato-Gastroenterology, University Hospital of Grenoble, University of Grenoble Alpes, France.
出版信息
United European Gastroenterol J. 2020 Jul;8(6):736-740. doi: 10.1177/2050640620921060. Epub 2020 Apr 23.
BACKGROUND AND AIMS
Crohn's disease (CD) frequently affects young women and may require surgery during pregnancy. Data regarding operation for CD in expectant mothers are scare.
MATERIALS AND METHODS
This was a retrospective nationwide survey from the GETAID Chirurgie. Any woman with CD undergoing surgery during pregnancy was eligible.
RESULTS
A total of 15 cases were collected between 1992 and 2015. Most operations were performed due to penetrating or stricturing complications. Mean gestational age at delivery was 34 weeks, with a mean birth weight of 2507 g. Maternal post-operative complications occurred in two-thirds of cases. Maternal mortality rate was 6.7% and neonatal mortality rate 9.1%.
CONCLUSIONS
This is the largest case series of surgery for CD during pregnancy. This operation may have significant morbidity and mortality for mother, fetus, and newborn. Indication needs to be tailored to maternal status, disease severity, and gestational age. Surgery should be managed by experienced gynecologists, physicians, and surgeons. Active CD may be associated with a greater risk to the fetus than the surgical procedure itself.
背景与目的
克罗恩病（CD）常影响年轻女性，孕期可能需要手术治疗。关于孕妇克罗恩病手术的数据十分匮乏。
材料与方法
这是一项来自GETAID外科的全国性回顾性调查。任何孕期接受克罗恩病手术的女性均符合条件。
结果
1992年至2015年间共收集到15例病例。多数手术是因穿透性或狭窄性并发症而进行。分娩时的平均孕周为34周，平均出生体重为2507克。三分之二的病例出现了产妇术后并发症。产妇死亡率为6.7%，新生儿死亡率为9.1%。
结论
这是孕期克罗恩病手术最大的病例系列。该手术对母亲、胎儿和新生儿可能具有显著的发病率和死亡率。手术指征需要根据产妇状况、疾病严重程度和孕周进行调整。手术应由经验丰富的妇科医生、内科医生和外科医生进行管理。活动期克罗恩病对胎儿的风险可能大于手术本身。
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