1.Analysis of surgery-related complications and risk factors of ileocolic Crohn's disease
Min'er ZHONG ; Bin WU ; Beizhan NIU ; Xiyu SUN ; Wuyang JI ; Yi XIAO ; Huizhong QIU
Chinese Journal of Digestive Surgery 2016;15(12):1165-1169
Objective To investigate the surgery-related complications and risk factors of ileocolic Crohn's disease (CD).Methods The retrospective case-control study was conducted.The clinicopathological data of 52 patients with ileocolic CD who underwent surgery at the Peking Union Medical College Hospital from January 2010 to April 2016 were collected.Observation indicators:(1) surgery-related complications,(2) risk factors analysis of surgery-related complications:gender,age of onset,preoperative body mass index (BMI),course of disease,smoking history,history of appendectomy,perianal lesions,oral ulcer,C-reactive protein (CRP),erythrocyte sedimentation rate,disease behavior,short crohn's disease activity index (sCDAI),preoperative amino salicylic acid therapy,preoperative hormone therapy,preoperative antituberculosis therapy,preoperative immunosuppressive agents therapy,preoperative biologic agents therapy,emergency operation,surgical method and ileocolic anastomosis method,(3) follow-up.The follow-up using outpatient examination and telephone interview was performed to detect recurrence of disease up to August 2016.Measurement data with normal distribution were represented as-x ± s.The univariate analysis was done using the chi-square test,and multivariate analysis was done using the Logistic regression model.Results (1) Surgery-related complications:of 52 patients,12 had postoperative complications.Four patients complicated with wound infection had good healing of the wound after debridement and dressing change.Of 4 patients with abdominal infection,3 were improved by anti-infection symptomatic treatment and 1 die of septic shock at postoperative day 1.One patient with intestinal obstruction had a smooth recovery after open adhesiolysis.One patient with intestinal fistula discharged from hospital due to a critical condition under families' requestion.One patient with acute cholecystitis and 1 with acute pancreatitis were respectively improved by conservative treatment.(2) Risk factors analysis of surgery-related complications:theresult of univariate analysis showed that sCDAI and emergency operation were the factors infecting surgery-relatedcomplications of ileocolic CD (x2 =6.299,8.494,P < 0.05).The result of multivariate analysis showed that sCDAI was an independent factor infecting surgery-related complications of ileocolic CD [OR =2.716,95% confidence interval (CI):1.216-6.066,P < 0.05].(3) Follow-up:all the 52 patients were followed up for 5-76 months with a median time of 39 months.During the follow-up,15 had recurrence of diseases and then underwent medical treatment.Conclusions Patients with ileocolic CD are easily complicated with wound infection and abdominal infection in the active period,and sCDAI is an independent factor infecting surgery-related complications of ileocolic CD.
2.Recent Advances on the Differences between Left- and Right-sided Colorectal Cancer.
Acta Academiae Medicinae Sinicae 2021;43(6):980-985
Right-sided colon cancer and left-sided colorectal cancer have significant differences in epidemiology,clinical features,tumor differentiation,response to treatment,prognosis,and molecular characteristics.The former has lower prevalence than the latter and is mainly associated with female and elderly patients,with poor tumor differentiation,strong invasion,poor prognosis,and weak response to epidermal growth factor receptor inhibitors.Thus,it is generally believed that the primary location of colorectal cancer is closely associated with prognosis,acting as an independent prognostic factor for therapeutic efficacy.Recent studies have revealed the genetic differences between right-sided colon cancer and left-sided colorectal cancer,providing explanations for the biological differences.This review summarizes the recent advances on the differences between left-and right-sided colorectal cancer.
Aged
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Colorectal Neoplasms/genetics*
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Female
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Humans
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Prognosis