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炎症性肠病患儿手术干预的早期及长期结果

EARLY AND LONG-TERM OUTCOME OF SURGICAL INTERVENTION IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE.

作者信息

Khosravi Farbod, Ziaeefar Pardis

机构信息

Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Arq Bras Cir Dig. 2020 Nov 20;33(2):e1518. doi: 10.1590/0102-672020200002e1518. eCollection 2020.

Abstract

BACKGROUND

Long-term complication-free survival chart in children with IBD . Although children with inflammatory bowel disease (IBD), disease control is possible through medical procedures, but surgical intervention is indicated in some cases.

AIM

To evaluated long-term surgical outcomes in children with IBD.

METHODS

This retrospective cohort study was done on 21 children suffering IBD with surgical indication admitted to a referral children hospital in Tehran in 2019. The baseline information was collected by reviewing the recorded files and children were followed-up to assess surgical outcome.

RESULTS

The rate of early complications after surgery was 47.6%; they included intestinal perforation in 4.8%, peritonitis in 4.8%, wound infection in 23.8%, pelvic abscesses in 14.3%, deep vein thrombosis in 4.8%, intestinal obstruction in 9.5%, pancreatitis in 9.5% and anal fissure in 4.8%. The mean duration of follow-up for patients was 6.79±4.24 years. The rate of delayed complications during follow up was 28.6%. Accordingly, long-term free-complication survival rate during 5-10 years after surgery was 92.3% and 56.4%, respectively. Among the early features, lack of prior drug treatment and bleeding as indication for surgery, were two predictors of long-term surgical complications.

CONCLUSION

Standard surgery in the treatment of IBD in children with surgical indication is associated with favorable outcome, although short- and long-term surgical complications are also predictable.

摘要

背景

炎症性肠病(IBD)患儿的长期无并发症生存图表。虽然炎症性肠病(IBD)患儿可通过医疗程序控制疾病,但在某些情况下仍需手术干预。

目的

评估IBD患儿的长期手术结局。

方法

本回顾性队列研究对2019年入住德黑兰一家转诊儿童医院的21例有手术指征的IBD患儿进行。通过查阅记录文件收集基线信息,并对患儿进行随访以评估手术结局。

结果

术后早期并发症发生率为47.6%;其中肠穿孔4.8%、腹膜炎4.8%、伤口感染23.8%、盆腔脓肿14.3%、深静脉血栓形成4.8%、肠梗阻9.5%、胰腺炎9.5%、肛裂4.8%。患者的平均随访时间为6.79±4.24年。随访期间延迟并发症发生率为28.6%。因此,术后5至10年的长期无并发症生存率分别为92.3%和56.4%。在早期特征中,术前未进行药物治疗以及以出血作为手术指征是长期手术并发症的两个预测因素。

结论

有手术指征的IBD患儿进行标准手术可取得良好结局,尽管短期和长期手术并发症也是可预测的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd16/7682153/6fa79f111db1/0102-6720-abcd-33-02-e1518-gf1a.jpg

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