Perforating and nonperforating indications in repeated surgeries for Crohn's disease  

作　　者：Wei-Song Shen Xiao-Hui Huang Rui-Qing Liu Chen-Yang Li Yi Li Wei-Ming Zhu 

机构地区：[1]Department of Gastrointestinal Surgery,Peking University People’s Hospital,Beijing 100044,China [2]Department of General Surgery,Chinese PLA General Hospital First Medical Center,Beijing 100853,China [3]Department of General Surgery,The affiliated Hospital of Qingdao University,Qingdao 266000,Shandong Province,China [4]Peking University School of Nursing,Peking University School of Nursing,Beijing 100191,China [5]Department of General Surgery,Jinling Hospital,Medical School of Nanjing University,Nanjing 210002,Jiangsu Province,China

出　　处：《World Journal of Clinical Cases》2022年第9期2733-2742,共10页世界临床病例杂志

基　　金：Supported by Peking University Medicine Fund of Fostering Young Scholars’ Scientific&Technological Innovation Supported by the Fundamental Research Funds for the Central Universities,No. BMU2021PYB009;Peking University People’s Hospital Research and Development Funds,No. RDY2020-14;National Natural Science Foundation of China,No. 82100546

摘　　要：BACKGROUND Despite advances in medical therapy for Crohn’s disease(CD),most patients with CD require repeated resection surgeries.AIM To analyze the perforating and nonperforating indications of repeated CD operations and identify the anastomosis characteristics for postoperative CD.METHODS We retrospectively reviewed 386 patients who underwent at least one resection for CD between 2003 and 2013.Clinical characteristics of each surgery were collected.Univariate and multivariate analyses were performed to determine risk factors for recurrence.RESULTS The indication for reoperation in CD tends to be the same as that for primary operation,i.e.,perforating disease tends to represent as perforating disease and nonperforating as nonperforating.Concordance was found between the first surgery and second surgery in terms of the indication for the operation(P=0.006),and the indication for the third surgery was also correlated with that for the second surgery(P=0.033).Even if the correlation of surgical indications between repeated operations,the rate of perforating indication for the second and third surgeries was significantly higher than that of the first surgery.In addition,the presence of perforating CD was a predictor of recurrence for both the first and second surgeries.Moreover,anastomotic lesions were the most common sites of recurrence after the operation.Based on the importance of anastomosis,anastomosis might be a new type of disease location for the classification of postoperative CD.CONCLUSION CD not only has stable characteristics but also progresses chronically.Perforation is a progressive surgical indication for Crohn’s disease.For CD after surgery,anastomosis may be a new classification of disease location.

关 键 词：Crohn’s Disease ANASTOMOSIS PERFORATION Nonperforating 

分 类 号：R656.7[医药卫生—外科学]