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Watchful Waiting After Radiological Guided Drainage of Intra-abdominal Abscess in Patients With Crohn's Disease Might Be Associated With Increased Rates of Stoma Construction
A. El-Hussuna, C. Steenholdt, ML. Merrild Karer, N. Nyggard Uldall Nielsen, A. Mujukian, PR. Fleshner, I. Iesalnieks, N. Horesh, U. Kopylov, H. Jacoby, HM. Al-Qaisi, F. Colombo, GM. Sampietro, MV. Marino, M. Ellebæk, N. Sørensen, V. Celentano, N....
Status neindexováno Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články
NLK
Directory of Open Access Journals
od 2019
PubMed Central
od 2020
ProQuest Central
od 2019-05-01
Nursing & Allied Health Database (ProQuest)
od 2019-05-01
Health & Medicine (ProQuest)
od 2019-05-01
Oxford Journals Open Access Collection
od 2019-05-01
ROAD: Directory of Open Access Scholarly Resources
od 2019
PubMed
37636010
DOI
10.1093/crocol/otad038
Knihovny.cz E-zdroje
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Management of spontaneous intra-abdominal abscess (IAA) in patients with Crohn's disease (CD) with radiologically guided percutaneous drainage (PD) was debated. METHODS: This is a secondary analysis from a multicenter, retrospective cohort study of all the patients with CD who underwent PD followed by surgery at 19 international tertiary centers. RESULTS: Seventeen patients (4.8%) who did not undergo surgery after PD were compared to those who had PD followed by surgical intervention 335/352 (95.2%). Patients who had PD without surgery were those with longer disease duration, more frequently had previous surgery for CD (laparotomies/laparoscopies), enteric fistula, on steroid treatment before and continue to have it after PD. Patients who had PD without subsequent surgical resection had a higher risk of stoma construction at later stages 8/17 (47.1%) versus 90/326 (27.6%) (P < .01). Patients with PD with no subsequent surgery had numerically higher rates of abscess recurrence 5/17 (29.4%) compared to those who had PD followed by surgery 45/335 (13.4%) the difference was not statistically significant (P = .07). CONCLUSIONS: Even with the low number of patients enrolled in this study who had PD of IAA without subsequent surgery, the findings indicate a markedly worse prognosis in terms of recurrence, length of stay, readmission, and stoma construction. Watchful waiting after PD to treat patients with spontaneous IAA might be indicated in selected patients with poor health status or poor prognostic factors.
Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello Palermo Italy
Chelsea and Westminster Hospital NHS Foundation Trust London UK
Colorectal Surgery Unit Hospital Universitario Madrid Del Henares Spain
Colorectal Surgery Unit Hospital Universitario Son Espases Mallorca Spain
Colorectal Surgery Vall d'Hebron University Hospital Barcelona Spain
Department of Biomedical Sciences IRCCS Humanitas Research Hospital Humanitas University Milan Italy
Department of Gastroenterology Herlev Hospital Herlev Denmark
Department of Surgery Aalborg University Aalborg Denmark
Department of Surgery Aalborg University Hospital Aalborg Denmark
Department of Surgery Cedars Sinai Medical Center Los Angeles California USA
Department of Surgery Hospital del Mar Spain
Department of Surgery Hvidovre Hospital Hvidovre Denmark
Department of Surgery St Mark's and Northwick Park Hospital London UK
Department of Surgery Städtisches Klinikum München Bogenhausen Munich Germany
Department of Surgery University Hospital La Fe University of Valencia Spain
Division of General and HPB Surgery Luigi Sacco Hospital Milano Italy
Faculty of Medicine Gazi University Ankara Turkey
Medicine Faculty Universidad Francisco de Vitoria Madrid Spain
OpenSourceResearch Collaboration Aalborg Denmark
School of Medicine Kocaeli University Kocaeli Turkey
Sheba Medical Center Sackler Medical School Tel Aviv University Ramat Gan Israel
Citace poskytuje Crossref.org
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