背景:回肠袋-肛门吻合术的恢复性结肠直肠切除术通过切除病变的大肠和保留自然排便途径,改善了溃疡性结肠炎患者的生活质量。尽管手术可能会改善关节先前存在的肠外表现,皮肤,和眼睛,肠外表现,尤其是原发性硬化性胆管炎可在结肠切除术后持续存在.
目的:肝脏诊断和治疗的系统评价,接头,皮肤,溃疡性结肠炎恢复性直肠结肠切除术和回肠袋-肛门吻合术患者的眼部表现。
方法:PubMed,谷歌学者,和Cochrane数据库。
方法:2001年1月至2023年7月间发表的关于原发性硬化性胆管炎和回肠袋肠外表现的相关文章的英文文献纳入了系统评价和荟萃分析指南的首选报告项目。
方法:包括原发性硬化性胆管炎和肠外表现的诊断和治疗。
方法:原发性硬化性胆管炎,肠外表现,袋的炎症性疾病及其管理。
结果:原发性硬化性胆管炎和肠外表现与囊炎有关,特别是慢性囊炎。原发性硬化性胆管炎与慢性囊炎和肠炎有关。和可能的囊袋瘤。然而,原发性硬化性胆管炎和囊炎的疾病严重程度和病程似乎不平行。尽管口服万古霉素或布地奈德已用于治疗原发性硬化性胆管炎相关囊炎,它们对原发性硬化性胆管炎病程的影响尚不清楚。袋的慢性炎症性疾病的生物治疗也可能有益于关节的并发肠外表现。皮肤,和眼睛。然而,关于炎症性眼袋疾病的严重程度与关节严重程度之间的相关性的研究,皮肤,眼病是缺乏的。
结论:这是一个定性的,不是病例系列和病例报告的定量审查。
结论:原发性硬化性胆管炎和关节的肠外表现,皮肤,和眼睛似乎与回肠袋的炎症性疾病有关。虽然囊炎的治疗似乎并不影响原发性硬化性胆管炎的病程,炎症性眼袋疾病的有效治疗,特别是生物制品,可能对关节并发疾病有好处,皮肤,和眼睛。见20分钟的研讨会视频。
BACKGROUND: Restorative proctocolectomy with IPAA improves the quality of life in patients with ulcerative colitis by the removal of diseased large bowel and preservation of the natural route of defecation. Although the surgery may improve preexisting extraintestinal manifestations in the joints, skin, and eyes, extraintestinal manifestations, particularly primary sclerosing cholangitis, can persist after colectomy.
OBJECTIVE: A systematic
review of diagnosis and treatment of liver, joint, skin, and eye manifestations in patients with restorative proctocolectomy and IPAA for ulcerative colitis.
METHODS: PubMed, Google Scholar, and Cochrane database.
METHODS: Relevant articles on primary sclerosing cholangitis and extraintestinal manifestations in ileal pouches published between January 2001 and July 2023 in English were included on the basis of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
METHODS: Diagnosis and treatment of primary sclerosing cholangitis and extraintestinal manifestations in patients with restorative proctocolectomy and IPAA were included.
METHODS: Association between primary sclerosing cholangitis, extraintestinal manifestations, and inflammatory disorders of the pouch and their management.
RESULTS: Primary sclerosing cholangitis and extraintestinal manifestations are associated with pouchitis, particularly chronic pouchitis. Primary sclerosing cholangitis is associated with chronic pouchitis, enteritis, and possible pouch neoplasia. However, the disease severity and course of primary sclerosing cholangitis and pouchitis do not appear to be parallel. Despite the fact that oral vancomycin or budesonide have been used to treat primary sclerosing cholangitis-associated pouchitis, their impact on the disease course of primary sclerosing cholangitis is not known. Biological therapy for chronic inflammatory disorders of the pouch may also be beneficial for the concurrent extraintestinal manifestations of the joints, skin, and eyes. However, studies on the correlation between the severity of inflammatory pouch disorders and the severity of joint, skin, and eye diseases are lacking.
CONCLUSIONS: This is a qualitative, not quantitative,
review of case series and case reports.
CONCLUSIONS: Primary sclerosing cholangitis and extraintestinal manifestations of the joints, skin, and eyes appear to be associated with inflammatory disorders of the ileal pouch. Although the treatment of pouchitis does not seem to affect the disease course of primary sclerosing cholangitis, effective therapy of inflammatory pouch disorders, particularly with biologics, likely benefits concurrent disorders of the joints, skin, and eyes. See video from the symposium .