目的:虽然Ogilvie综合征在大约70年前被首次描述,其病因和发病机制尚不完全清楚。但更重要的是,也不清楚何时采用哪种治疗策略.
方法:纳入我们机构17年(2002-2019年)被诊断为Ogilvie综合征的患者,并对不同的治疗策略进行回顾性评估:保守,内窥镜,或外科手术。
结果:该研究包括71例患者,21例患者接受保守治疗,25例接受内镜治疗的患者,和25名接受手术的患者。然而,主要接受保守治疗的38%患者(n=8)失败,不得不接受内窥镜检查甚至手术。同样,8例(32%)主要接受内窥镜治疗的患者必须进行手术。在逻辑回归分析中,只有结肠直径≥11cm(p=0.01)可以预测内镜治疗缺乏治疗成功.两组间90天死亡率和总生存期相当。
结论:由于大约三分之一的患者保守治疗和内镜治疗失败,截止直径≥11cm可能是评估手术治疗的适当参数.
OBJECTIVE: Although
Ogilvie\'s syndrome was first described about 70 years ago, its etiology and pathogenesis are still not fully understood. But more importantly, it is also not clear when to approach which therapeutic strategy.
METHODS: Patients who were diagnosed with
Ogilvie\'s syndrome at our institution in a 17-year time period (2002-2019) were included and retrospectively evaluated regarding different therapeutical strategies: conservative, endoscopic, or surgical.
RESULTS: The study included 71 patients with 21 patients undergoing conservative therapy, 25 patients undergoing endoscopic therapy, and 25 patients undergoing surgery. However, 38% of patients (n = 8) who were primarily addressed for conservative management failed and had to undergo endoscopy or even surgery. Similarly, 8 patients (32%) with primarily endoscopic treatment had to proceed for surgery. In logistic regression analysis, only a colon diameter ≥ 11 cm (p = 0.01) could predict a lack of therapeutic success by endoscopic treatment. Ninety-day mortality and overall survival were comparable between the groups.
CONCLUSIONS: As conservative and endoscopic management fail in about one-third of patients, a cutoff diameter ≥ 11 cm may be an adequate parameter to evaluate surgical therapy.