Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona, Italy.
UOC of General and Minimally Invasive Surgery, San Paolo Hospital, Civitavecchia, Rome, Italy -
Minerva Surg. 2022 Jun;77(3):272-280. doi: 10.23736/S2724-5691.22.09369-8. Epub 2022 Feb 17.
Inflammatory bowel disease (IBD) associated colorectal cancer represents the 1-2% of all patients affected by colorectal carcinoma, but it is frequent responsible for death in these patients. Aim of this systematic review was to report the complications after bowel resection in patients with IBD associated cancer.
A systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. The search was carried out in PubMed, Embase, Cochrane and Web of Science databases. A total of 54,084 articles were found. Of these 38,954 were eliminated because were duplicates between the searches. Of the remaining 15,130 articles, 14,888 were excluded after screening title and abstract.
Two-hundred-forty-two articles were fully analyzed, and 239 further articles were excluded. Finally, three articles were included for a total of 63 patients. Overall, 38 early postoperative complications (60.3%) were observed. Of these, anastomotic leakage occurred in 13 patients (20.6%). The indication for surgery was ulcerative colitis in 52 patients (82.5%), Crohn's disease in 8 patients (12.7%) and indeterminate colitis in 3 patients (4.8%). Intraoperative complications, readmission and postoperative mortality were not observed.
Complication rate after bowel resection for IBD associated cancer is not different from complication rate after colorectal surgery for other diseases. Given the high probability of developing a cancer and the time correlated occurrence of malignancy in IBD patients, it should be debated if a surgical resection should be performed as soon as dysplasia is detected in IBD patients or earlier in their life.
炎症性肠病（IBD）相关结直肠癌占所有结直肠癌患者的 1-2%，但它是这些患者死亡的主要原因。本系统评价的目的是报告 IBD 相关癌症患者肠切除术后的并发症。
根据系统评价和荟萃分析报告的首选项目进行了系统评价。在 PubMed、Embase、Cochrane 和 Web of Science 数据库中进行了搜索。共发现 54084 篇文章。其中 38954 篇是搜索结果中的重复项。在剩下的 15130 篇文章中，经过标题和摘要筛选后，有 14888 篇被排除。
对 242 篇全文进行了分析，排除了 239 篇。最终，共有 63 例患者纳入 3 篇文章进行分析。总的来说，观察到 38 例早期术后并发症（60.3%）。其中，13 例（20.6%）发生吻合口漏。手术指征为溃疡性结肠炎 52 例（82.5%），克罗恩病 8 例（12.7%），不确定结肠炎 3 例（4.8%）。术中并发症、再次入院和术后死亡率均未观察到。
IBD 相关癌症肠切除术后的并发症发生率与其他疾病的结直肠手术并发症发生率无差异。鉴于 IBD 患者发生癌症的概率较高，以及恶性肿瘤在 IBD 患者中的发生时间相关性，对于 IBD 患者，一旦发现异型增生，是否应尽快进行手术切除，还是应更早进行手术切除，值得商榷。
