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肠道研究:克罗恩病的预期临时造口术。国际多中心研究方案。

The INTESTINE study: INtended TEmporary STomas In crohN's diseasE. Protocol for an international multicentre study.

机构信息

Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

Department of Surgery and Cancer, Imperial College, London, UK.

出版信息

Updates Surg. 2022 Oct;74(5):1691-1696. doi: 10.1007/s13304-022-01345-y. Epub 2022 Aug 12.

DOI:10.1007/s13304-022-01345-y
PMID:35962277
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9481503/
Abstract

Surgery for ileocolonic Crohn's disease can result in temporary or permanent stoma formation which can be associated with morbidity as parastomal and incisional hernias, readmissions due to obstruction or high stoma output, and have a negative impact on quality of life. We propose an international retrospective trainee-led study of the outcomes of temporary stomas in patients with Crohn's disease. We aim to evaluate both the short-term (6 month) and mid-term (18 month) outcomes of temporary stomas in patients with Crohn's Disease. Retrospective, multicentre, observational study including all patients who underwent elective or emergency surgery for ileal, colonic and ileocolonic Crohn's disease during a 4-year study period. Primary outcome is the proportion of patients who still have an ileostomy or colostomy 18 months after the initial surgery. Secondary outcomes: complications related to stoma formation and stoma reversal surgery; time interval between stoma formation and stoma reversal; risk factors for stoma formation and non-reversal of the stoma. We present the study protocol for a trainee-led, multicentre, observational study. Previous research has demonstrated significant heterogeneity surrounding the formation and the timing of reversal surgery in patients having a temporary ileostomy following colorectal cancer surgery, highlighting the need to address these same questions in Crohn's disease, which is the aim of our research.

摘要

回肠结肠克罗恩病的手术可能导致临时或永久性造口形成,这可能与造口旁和切口疝的发病率、因梗阻或高造口输出导致的再入院以及对生活质量产生负面影响有关。我们提出了一项针对克罗恩病患者临时造口结局的国际回顾性学员主导研究。我们旨在评估克罗恩病患者临时造口的短期(6 个月)和中期(18 个月)结局。这是一项回顾性、多中心、观察性研究,包括在 4 年研究期间接受择期或急诊手术治疗回肠、结肠和回结肠克罗恩病的所有患者。主要结局是初始手术后 18 个月仍有回肠造口或结肠造口的患者比例。次要结局:与造口形成和造口逆转手术相关的并发症;造口形成和造口不逆转之间的时间间隔;造口形成和不逆转的风险因素。我们提出了一项由学员主导的多中心观察性研究的研究方案。先前的研究表明,在接受结直肠癌手术后行临时性回肠造口的患者中,造口形成和逆转手术的时间存在显著异质性,这突出表明需要在克罗恩病中解决这些相同的问题,这也是我们研究的目的。

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引用本文的文献

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本文引用的文献

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Overall readmissions and readmissions related to dehydration after creation of an ileostomy: a systematic review and meta-analysis.回肠造口术后总体再入院率和与脱水相关的再入院率:系统评价和荟萃分析。
Tech Coloproctol. 2022 May;26(5):333-349. doi: 10.1007/s10151-022-02580-6. Epub 2022 Feb 22.
2
Inflammatory Bowel Disease patients requiring surgery can be treated in referral centres regardless of the COVID-19 status of the hospital: results of a multicentric European study during the first COVID-19 outbreak (COVIBD-Surg).无论医院的 COVID-19 状况如何,需要手术的炎症性肠病患者都可以在转诊中心接受治疗:COVID-19 首次爆发期间(COVIBD-Surg)一项多中心欧洲研究的结果。
Updates Surg. 2021 Oct;73(5):1811-1818. doi: 10.1007/s13304-021-01119-y. Epub 2021 Jun 26.
3
Factors impacting time to ileostomy closure after anterior resection: the UK closure of ileostomy timing cohort study (CLOSE-IT).影响前切除术后回肠造口关闭时间的因素:英国回肠造口关闭时间队列研究(CLOSE-IT)。
Colorectal Dis. 2021 May;23(5):1109-1119. doi: 10.1111/codi.15531. Epub 2021 Feb 18.
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National variations in perioperative assessment and surgical management of Crohn's disease: a multicentre study.克罗恩病围手术期评估与手术管理的国家差异:一项多中心研究。
Colorectal Dis. 2021 Jan;23(1):94-104. doi: 10.1111/codi.15334. Epub 2020 Sep 17.
5
Inflammatory bowel disease (IBD) position statement of the Italian Society of Colorectal Surgery (SICCR): general principles of IBD management.意大利结直肠外科学会(SICCR)炎症性肠病(IBD)立场声明:IBD 管理的一般原则。
Tech Coloproctol. 2020 Feb;24(2):105-126. doi: 10.1007/s10151-019-02145-0. Epub 2020 Jan 25.
6
ECCO Guidelines on Therapeutics in Crohn's Disease: Surgical Treatment.ECCO 指南:克罗恩病治疗——手术治疗。
J Crohns Colitis. 2020 Feb 10;14(2):155-168. doi: 10.1093/ecco-jcc/jjz187.
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