Speranza V
Universita di Roma La Sapienza, Policlinico Umberto I.
Chirurg. 1995 Aug;66(8):751-6.
From 1965 to 1990, postoperative risk factors (age, sex, preoperative history of CD, initial location of CD, length of affected intestinum, extent of bowel resection) for recurrence of Crohn's Disease (CD) were retrospectively analysed from data of 172 patients (104 men, 68 women; age 14 to 65 yrs.) with primary bowel resection and compared with the international literature. The mean follow-up interval was 10 (1-21) years. Additionally full thickness biopsies from resection margins of 66 consecutive ileocecal specimen (45 men, 21 women; age 21-70 years) with ileitis were studied, histopathologically classified into 3 groups and correlated with the rate, manifestation and onset of early recurrence. The cumulative CD recurrence rate was 69% after 10 years and 86.4% after 15 years. There was no statistically significant correlation between recurrence rate and age, sex, initial location or extent of bowel resection, only an higher rate with an preoperative duration of CD longer than 5 years (p < 0.05). The histopathology of the ileocecal resection specimen showed no statistically significant differences of the recurrence rate within the 3 groups. Surgery cannot minimize the recurrence rate of CD after resection but do clearly improve the quality of life.
1965年至1990年期间,我们对172例(104例男性,68例女性;年龄14至65岁)接受初次肠切除的患者的数据进行回顾性分析,以研究克罗恩病(CD)复发的术后危险因素(年龄、性别、术前CD病史、CD的初始部位、受累肠段长度、肠切除范围),并与国际文献进行比较。平均随访时间为10(1至21)年。此外,我们还对66例连续的患有回肠炎的回盲部标本(45例男性,21例女性;年龄21至70岁)的切除边缘进行全层活检,进行组织病理学分类为3组,并与早期复发的发生率、表现和发病时间相关联。CD的累积复发率在10年后为69%,15年后为86.4%。复发率与年龄、性别、初始部位或肠切除范围之间无统计学显著相关性,仅术前CD病程超过5年的复发率较高(p<0.05)。回盲部切除标本的组织病理学显示3组内复发率无统计学显著差异。手术虽不能使CD切除术后的复发率降至最低,但确实能明显改善生活质量。