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肠道白塞病的外科治疗

Surgical treatment of intestinal Behçet's disease.

作者信息

Lee K S, Kim S J, Lee B C, Yoon D S, Lee W J, Chi H S

机构信息

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Yonsei Med J. 1997 Dec;38(6):455-60. doi: 10.3349/ymj.1997.38.6.455.

Abstract

From 1983 to 1994, we diagnosed 37 cases of intestinal Behçet's disease and performed operations on 26 patients at the Surgical Department of Yonsei University Medical Center. Sixty percent of patients were in their teens and twenties (mean age: 36.4 years). Preoperative diagnosis of Behçet's disease was correctly made in only 8 cases (30%). In 32 cases (86.5%), the lesion was localized regardless of the number of ulcers. A solitary ulcer was observed in 22 cases (60%), while multiple ulcers were present in 15 cases. A recurrence after the initial operation was observed in 12 patients (46.1%) and reoperation was performed 19 times. Fifty percent of recurrence developed within 2 years after each operation. The type of operation, the location of lesion and the number of ulcers did not appear to be related to the recurrence. As a preoperative diagnosis is difficult and the recurrence rate is high, post- operative periodic follow-up with radiography and endoscopy are strongly recommended. At the time of operation, the entire bowel should be examined and bowel resection should include a generous normal resection margin as well as skip lesions.

摘要

1983年至1994年期间,我们在延世大学医学中心外科诊断出37例肠道白塞病患者,并对其中26例患者实施了手术。60%的患者年龄在十几岁和二十几岁(平均年龄:36.4岁)。术前仅8例(30%)正确诊断为白塞病。32例(86.5%)患者的病变局限,与溃疡数量无关。22例(60%)观察到单个溃疡,15例有多个溃疡。12例(46.1%)患者初次手术后复发,再次手术19次。50%的复发发生在每次手术后2年内。手术方式、病变部位和溃疡数量似乎与复发无关。由于术前诊断困难且复发率高,强烈建议术后定期进行影像学和内镜随访。手术时,应检查整个肠道,肠切除应包括足够宽的正常切缘以及跳跃性病变。

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