PURPOSE: This prospective study was designed to identify factors that could predict conversion in patients undergoing first laparoscopic ileocecal resection for Crohn’ s disease. METHODS: Between 1998 and 2004, 69 co...PURPOSE: This prospective study was designed to identify factors that could predict conversion in patients undergoing first laparoscopic ileocecal resection for Crohn’ s disease. METHODS: Between 1998 and 2004, 69 consecutive patients (32 males; mean age, 32 ± 9 years) who had undergone a first laparoscopic ileocecal resection for Crohn’ s disease were included in a prospective study. Twenty-one patients (30 percent) were converted into laparotomy. Possible factors for conversion were analyzed by both univariate and multivariate analyses. RESULTS: No patient died. Four patients (9 percent; 2 in each group) required five reoperations because of intraperitoneal hemorrhage (n = 1), anastomotic fistula (n = 3), and small bowel obstruction (n = 1). Mean hospital stay was significantly increased in converted compared with laparoscopic patients (9 ± 4 vs. 7 ± 3 days; P < 0.05). On univariate analysis, more than three episodes of acute flare of Crohn’ s disease (P = 0.02), male gender (P = 0.03), preoperative immunosuppressive drugs (P = 0.04), intra-abdominal abscess or fistula at the time of laparoscopy (P = 0.02), and resection of other intestinal segment (P = 0.02) were factors that predicted conversion. On multivariate analysis, recurrent medical episodes of Crohn’ s disease (odds ratio, 2; 95 percent confidence interval, 1-4), and intra-abdominal abscess or fistula at the time of laparoscopy (odds ratio, 15; 95 percent confidence interval, 4-78) were the two independent risk factors for conversion. CONCLUSIONS: This prospective study demonstrated that the severity of the disease increased significantly the conversion rate of the first laparoscopic ileocecal resection. Knowledge of these risk factors for conversion could be helpful in preoperative preparation and counseling of patients.展开更多
1 前言准确评定饲料的营养价值是配制全价饲料提高饲料利用率的先行性技术之一。在饲料营养价值中有效能更为重要,因而准确评定饲料能值的方法是国内外学者十分关注的一大问题。Sibbald I R(1976)提出以生物学试验方法实测饲料真代谢能(...1 前言准确评定饲料的营养价值是配制全价饲料提高饲料利用率的先行性技术之一。在饲料营养价值中有效能更为重要,因而准确评定饲料能值的方法是国内外学者十分关注的一大问题。Sibbald I R(1976)提出以生物学试验方法实测饲料真代谢能(TME)值,其后。在这方面又陆续地进行了不少研究工作。展开更多
文摘PURPOSE: This prospective study was designed to identify factors that could predict conversion in patients undergoing first laparoscopic ileocecal resection for Crohn’ s disease. METHODS: Between 1998 and 2004, 69 consecutive patients (32 males; mean age, 32 ± 9 years) who had undergone a first laparoscopic ileocecal resection for Crohn’ s disease were included in a prospective study. Twenty-one patients (30 percent) were converted into laparotomy. Possible factors for conversion were analyzed by both univariate and multivariate analyses. RESULTS: No patient died. Four patients (9 percent; 2 in each group) required five reoperations because of intraperitoneal hemorrhage (n = 1), anastomotic fistula (n = 3), and small bowel obstruction (n = 1). Mean hospital stay was significantly increased in converted compared with laparoscopic patients (9 ± 4 vs. 7 ± 3 days; P < 0.05). On univariate analysis, more than three episodes of acute flare of Crohn’ s disease (P = 0.02), male gender (P = 0.03), preoperative immunosuppressive drugs (P = 0.04), intra-abdominal abscess or fistula at the time of laparoscopy (P = 0.02), and resection of other intestinal segment (P = 0.02) were factors that predicted conversion. On multivariate analysis, recurrent medical episodes of Crohn’ s disease (odds ratio, 2; 95 percent confidence interval, 1-4), and intra-abdominal abscess or fistula at the time of laparoscopy (odds ratio, 15; 95 percent confidence interval, 4-78) were the two independent risk factors for conversion. CONCLUSIONS: This prospective study demonstrated that the severity of the disease increased significantly the conversion rate of the first laparoscopic ileocecal resection. Knowledge of these risk factors for conversion could be helpful in preoperative preparation and counseling of patients.
