■本研究的目的是调查与小肠切除术(SBR)后克罗恩病(CD)小肠梗阻(SBO)发展相关的危险因素,这些因素不是由于活动性/复发性炎症。
■我们对患有活动性或复杂性CD的SBR患者进行了一项回顾性队列研究。抽象数据包括人口统计,表型,治疗CD,内镜疾病复发,和几个手术变量。主要结果是SBR后5年内发生非炎症性SBO(NI-SBO)。
■共纳入335例患者。6个月时NI-SBO的累计费率,1年,5年为5年(1.5%),8(2.4%),和29(8.9%),分别。与NI-SBO发展相关的变量是手术边缘的活动性宏观或微观炎症(13(56%)与65(27%),P=0.004),开放切除术(vs.腹腔镜切除术)(12(41.4%)与60(19.5%),P=0.0006)和先前切除的中位数较高(2(四分位距(IQR)2-3)与1(IQR1-2),P=0.0002)。只有21%的发生NI-SBO的患者需要手术干预。
■在CD中SBR后NI-SBO的发生率较低,并且与切除肠边缘的炎症有关,之前的肠切除术,开腹手术.大多数NI-SBO都通过医疗管理来解决。
UNASSIGNED: The aim of the study was to investigate the risk factors associated with the development of small bowel obstruction (SBO) in Crohn\'s disease (CD) after small bowel resection (SBR) that are not due to active/recurrent inflammation.
UNASSIGNED: We conducted a retrospective cohort study of patients who had SBR for active or complicated CD. Abstracted data included demographics, phenotype, therapies for CD, endoscopic disease recurrence, and several surgical variables. The primary outcome was the development of non-inflammatory SBO (NI-SBO) within 5 years after SBR.
UNASSIGNED: A total of 335 patients were included. The cumulative rates of NI-SBO at 6 months, 1 year, and 5 years were 5 (1.5%), 8 (2.4%), and 29 (8.9%), respectively. Variables associated with the development of NI-SBO were active macroscopic or microscopic inflammation in the surgical margins (13 (56%) vs. 65 (27%), P = 0.004), open resection (vs. laparoscopic resection) (12 (41.4%) vs. 60 (19.5%), P = 0.0006) and a higher median number of previous resections (2 (interquartile range (IQR) 2 - 3) vs. 1 (IQR 1 - 2), P = 0.0002). Only 21% of patients who developed NI-SBO required surgical intervention.
UNASSIGNED: The incidence of NI-SBO after SBR in CD is low and associated with inflammation at the margins of the resected bowel, previous bowel resections, and an open laparotomy approach. Most NI-SBOs resolve with medical management.