Amin Rutvi, Mansabdar Aditya, Gu Hyundam, Gangineni Bhavani, Mehta Neev, Patel Harini, Patel Neel, Laller Srishti, Vinayak Suprada, Abdulqader Mohammed Ali, Jain Hardik, Rekhraj Amitjeet Singh, Adimoulame Harshini, Singh Gurinder, Moonjely Davis Jose, Patel Urvish, Gill Harmeet
Department of Medicine, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat 395010, India.
Department of Medicine, First Faculty of Medicine, Charles University, Prague 12108, Czechia.
Gastroenterology Res. 2024 Apr;17(2):90-99. doi: 10.14740/gr1672. Epub 2024 Apr 30.
Inflammatory bowel disease (IBD) is a group of chronic inflammatory gastrointestinal disorders that are caused by genetic susceptibility and environmental factors and affects a significant portion of the global population. The gut-associated lymphoid tissue (GALT) is known to play a crucial role in immune modulation and maintaining gut microbiota balance. Dysbiosis in the latter has a known link to IBD. Therefore, the increasing prevalence of adenoidectomy in children should be explored for its potential association with IBD. The objective of this paper was to assess the association between adenoid tissue removal and the risk of developing Crohn's disease (CD) and ulcerative colitis (UC).
We conducted a pooled meta-analysis to evaluate the extended clinical outcomes in patients who underwent appendicectomy and tonsillectomy compared to those who did not. Our approach involved systematically searching the PubMed database for relevant observational studies written in English. We followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines to collect data from various time periods, and to address the diversity in study results; we employed a random-effects analysis that considered heterogeneity. For outcomes, odds ratios (ORs) were pooled using a random-effects model.
Seven studies, out of a total of 114,537, met our inclusion criteria. Our meta-analysis revealed a significant association between appendicectomy and CD (OR: 1.57; 95% confidence interval (CI): 1.01 - 2.43; heterogeneity I = 93%). Similarly, we found a significant association between tonsillectomy and CD (OR: 1.93; 95% CI: 0.96 - 3.89; I = 62%). However, no significant association was observed between appendicectomy and UC (OR: 0.60; 95% CI: 0.24 - 1.47; I = 96%), while a modest association was found between tonsillectomy and UC (OR: 1.24; 95% CI: 1.18 - 1.30; I = 0%).
In summary, we found that the trend of appendicectomy is linked to higher odds of CD, and tonsillectomy is more likely associated with increased odds for both CD and UC, with a risk of bias present.
炎症性肠病（IBD）是一组慢性炎症性胃肠道疾病，由遗传易感性和环境因素引起，影响着全球相当一部分人口。已知肠道相关淋巴组织（GALT）在免疫调节和维持肠道微生物群平衡中起关键作用。后者的生态失调与IBD有已知联系。因此，应探讨儿童腺样体切除术患病率上升与其与IBD的潜在关联。本文的目的是评估腺样体组织切除与克罗恩病（CD）和溃疡性结肠炎（UC）发病风险之间的关联。
我们进行了一项汇总荟萃分析，以评估接受阑尾切除术和扁桃体切除术的患者与未接受者相比的扩展临床结果。我们的方法包括系统地在PubMed数据库中搜索用英文撰写的相关观察性研究。我们遵循流行病学观察性研究荟萃分析（MOOSE）指南，从不同时间段收集数据，并为解决研究结果的多样性；我们采用了考虑异质性的随机效应分析。对于结果，使用随机效应模型汇总比值比（OR）。
在总共114537项研究中，有7项符合我们的纳入标准。我们的荟萃分析显示阑尾切除术与CD之间存在显著关联（OR：1.57；95%置信区间（CI）：1.01 - 2.43；异质性I = 93%）。同样，我们发现扁桃体切除术与CD之间存在显著关联（OR：1.93；95% CI：0.96 - 3.89；I = 62%）。然而，未观察到阑尾切除术与UC之间存在显著关联（OR：0.60；95% CI：0.24 - 1.47；I = 96%），而发现扁桃体切除术与UC之间存在适度关联（OR：1.24；95% CI：1.18 - 1.30；I = 0%）。
总之，我们发现阑尾切除术的趋势与CD的较高发病几率相关，扁桃体切除术更可能与CD和UC的发病几率增加相关，存在偏倚风险
