家族性腺瘤性息肉病患者行回肠贮袋肛管吻合术是否会增加硬纤维瘤的风险？
Does ileoanal pouch surgery increase the risk of desmoid in patients with familial adenomatous polyposis?
机构信息
Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, 26 Yuancun Er Heng Rd., Guangzhou, 510655, Guangdong, China.
Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
出版信息
Int J Colorectal Dis. 2020 Aug;35(8):1599-1605. doi: 10.1007/s00384-020-03578-y. Epub 2020 May 20.
PURPOSE
Patients with familial adenomatous polyposis (FAP) may undergo either ileorectal anastomosis (IRA) or ileal pouch anal anastomosis (IPAA) depending on the degree of rectal involvement. Desmoid tumors (DTs) may arise postoperatively. Whether IPAA is associated with a higher risk of DTs as compared with IRA remains controversial. The purpose of this study was to determine whether IPAA increased the risk of DTs by analyzing the published data that compared IRA and IPAA as the primary treatment for FAP.
METHODS
A metaanalysis was performed to analyze the published data between 1989 and 2019. IRA and IPAA were compared with respect to the incidence of DTs.
RESULTS
Eight retrospective studies with a total of 1072 patients were identified: 491 underwent IPAA and 581 IRA. There was no significant difference in the incidence of DTs between IPAA and IRA (11.81% vs. 9.47%, OR 0.95, P = 0.85). Meanwhile, the overall complication (42.97% vs. 36.76%, OR 1.32, P = 0.11), incidence of cancer (4.88% vs. 8.37%, OR 0.28, P = 0.26), and overall mortality (0.33% vs. 5.20%, OR 0.49, P = 0.53) were comparable too.
CONCLUSION
Ileoanal pouch surgery is associated with similar risk of desmoid in patients with FAP after surgery.
目的
家族性腺瘤性息肉病（FAP）患者可能根据直肠受累程度接受回肠直肠吻合术（IRA）或回肠储袋肛管吻合术（IPAA）。术后可能会出现硬纤维瘤（DTs）。与 IRA 相比，IPAA 是否与更高的 DTs 风险相关仍存在争议。本研究旨在通过分析比较 IRA 和 IPAA 作为 FAP 主要治疗方法的已发表数据，确定 IPAA 是否会增加 DTs 的风险。
方法
对 1989 年至 2019 年发表的数据进行荟萃分析。比较 IRA 和 IPAA 之间 DTs 的发生率。
结果
共确定了 8 项回顾性研究，共 1072 例患者：491 例行 IPAA，581 例行 IRA。IPAA 和 IRA 之间 DTs 的发生率无显著差异（11.81% vs. 9.47%，OR 0.95，P=0.85）。同时，总体并发症（42.97% vs. 36.76%，OR 1.32，P=0.11）、癌症发生率（4.88% vs. 8.37%，OR 0.28，P=0.26）和总死亡率（0.33% vs. 5.20%，OR 0.49，P=0.53）也相似。
结论
在 FAP 患者中，回肠储袋肛管吻合术与术后发生硬纤维瘤的风险相似。
Zotero 插件