期刊
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
卷 22, 期 9, 页码 1061-1069出版社
SPRINGER
DOI: 10.1007/s00384-007-0329-4
关键词
Crohn's disease; recurrence; stapled side-to-side anastomosis; handsewn side-to-side anastomosis
Background/aims Anastomotic recurrence after bowel resection is a major problem in Crohn's disease (CD) surgery. The aims of this retrospective study are to assess the role of anastomotic configuration, the type of suture and the type of surgical approach (laparoscopy-assisted vs laparotomy) in CD recurrence. Secondary end points were to identify any possible predictor that would help the selection of patients for medical prophylaxis. Materials and methods In this retrospective study, we enrolled 141 consecutive patients who had undergone ileocolonic resection for CD. Univariate actuarial analysis was performed according to demographic, clinical and surgical predictors. Variables that resulted to be significant at the univariate analysis were included in two multivariate Cox proportional hazards models that analyzed symptomatic and surgical recurrence, respectively. Results In the long-term, handsewn side-to-side anastomosis reported a significantly lower surgical recurrence rate than stapled end-to-side (p<0.05). At multivariate analysis, anastomosis type, surgical and intestinal complications (p<0.01) and age at CD onset (p<0.05) resulted to be significant predictors for re-operation for CD recurrence. Multivariate analysis showed that surgical complication was also a significant predictor of symptomatic recurrence. Conclusions Side-to-side anastomosis configuration seems to delay re-operation and can be assumed as the standard configuration in ileocolonic anastomosis in CD. Postoperative complications and young age at disease onset might be a signal of aggressive CD that may warrant prophylactic pharmacological therapy.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据