PDF(Pubmed)
Abstract：
UNASSIGNED: Despite advances in medical treatments, most patients with Crohn\'s disease (CD) will still require surgery, with 20%-50% needing redo surgery within 10 years after the primary procedure. There is no consensus on the application of laparoscopic redo surgery for recurrent CD.
UNASSIGNED: This study included 107 patients with CD who underwent surgery from 2012 to 2020 at Osaka University Hospital. All procedures were laparoscopic. Patients were grouped based on whether the surgery was redo or primary for evaluation of the safety and feasibility of laparoscopic redo surgery.
UNASSIGNED: The study included 40 patients undergoing redo surgery and 67 having primary surgery. The median age at the time of the procedure was higher for those undergoing redo surgery (43 years vs 34 years, P < 0.0031), as were the duration of CD (16.5 years vs 8.3 years, P < 0.0012) and number of operating minutes (231.0 min vs 169.0 min, P < 0.0001). The remnant bowel length was shorter in the redo surgery group (270.0 cm vs 410.0 cm, P < 0.0001). Rates of open conversion were comparable between the two groups (10.0% vs 3.0%, P = 0.127), as were postoperative complications (32.5% vs 20.9%, P = 0.1812).
UNASSIGNED: These results suggest that laparoscopic redo surgery is safe and feasible, with comparable conversion rates and postoperative complications in experienced institutions.
UNASSIGNED: This study included 107 patients with CD who underwent surgery from 2012 to 2020 at Osaka University Hospital. All procedures were laparoscopic. Patients were grouped based on whether the surgery was redo or primary for evaluation of the safety and feasibility of laparoscopic redo surgery.
UNASSIGNED: The study included 40 patients undergoing redo surgery and 67 having primary surgery. The median age at the time of the procedure was higher for those undergoing redo surgery (43 years vs 34 years, P < 0.0031), as were the duration of CD (16.5 years vs 8.3 years, P < 0.0012) and number of operating minutes (231.0 min vs 169.0 min, P < 0.0001). The remnant bowel length was shorter in the redo surgery group (270.0 cm vs 410.0 cm, P < 0.0001). Rates of open conversion were comparable between the two groups (10.0% vs 3.0%, P = 0.127), as were postoperative complications (32.5% vs 20.9%, P = 0.1812).
UNASSIGNED: These results suggest that laparoscopic redo surgery is safe and feasible, with comparable conversion rates and postoperative complications in experienced institutions.
摘要：
■尽管医学治疗取得了进展，大多数克罗恩病（CD）患者仍需要手术，20％-50％的人在初次手术后10年内需要重做手术。关于腹腔镜重做手术治疗复发性CD的应用尚无共识。
■本研究纳入了2012年至2020年在大阪大学医院接受手术治疗的107名CD患者。所有手术均为腹腔镜手术。根据手术是重做还是主要手术对患者进行分组，以评估腹腔镜重做手术的安全性和可行性。
该研究包括40名接受重做手术的患者和67名接受初次手术的患者。接受重做手术的患者在手术时的中位年龄较高（43岁vs34岁，P<0.0031),CD的持续时间(16.5年对8.3年，P<0.0012）和运行分钟数（231.0分钟vs169.0分钟，P<0.0001)。重做手术组的残余肠长度较短（270.0cmvs410.0cm，P<0.0001)。两组的开放转化率相当（10.0％vs3.0％，P=0.127),术后并发症（32.5%vs20.9%，P=0.1812）。
■这些结果表明腹腔镜重做手术是安全可行的，在有经验的机构中具有相当的转换率和术后并发症。
■本研究纳入了2012年至2020年在大阪大学医院接受手术治疗的107名CD患者。所有手术均为腹腔镜手术。根据手术是重做还是主要手术对患者进行分组，以评估腹腔镜重做手术的安全性和可行性。
该研究包括40名接受重做手术的患者和67名接受初次手术的患者。接受重做手术的患者在手术时的中位年龄较高（43岁vs34岁，P<0.0031),CD的持续时间(16.5年对8.3年，P<0.0012）和运行分钟数（231.0分钟vs169.0分钟，P<0.0001)。重做手术组的残余肠长度较短（270.0cmvs410.0cm，P<0.0001)。两组的开放转化率相当（10.0％vs3.0％，P=0.127),术后并发症（32.5%vs20.9%，P=0.1812）。
■这些结果表明腹腔镜重做手术是安全可行的，在有经验的机构中具有相当的转换率和术后并发症。
