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आयतन 1, मुद्दा 2 (2016)

शोध आलेख

Prognosis of Ulcerative Colitis Colorectal Cancer vs. Sporadic Colorectal Cancer: Propensity Score Matching Analysis

Han YD, Al Bandar MH, Dulskas A, Cho MS, Hur H

Background: Ulcerative colitis (UC) harbours a high risk of UC-associated colorectal cancer (UCCC), which is important cause of morbidity and mortality in patients with inflammatory bowel disease. Overall survival (OS) of patients with UCCC has not been addressed well in the literature. Thus, we compared oncologic outcome of UCCC and sporadic colorectal cancer (SCC) using propensity score matching analysis. Methods: Propensity score matching was performed for 36 patients, a 1:1 matching method stratified into 18 in UCCC and 18 patients in SCC. Matched variables were sex, age, body mass index, tumour stage, histology, preoperative carcinoembryonic antigen (CEA) level, and adjuvant treatment status. Patients with SCC or UCCC were retrospectively retrieved from our database from March 2000 to December 2015. All patients had undergone either oncological segmental resection or total proctocolectomy. Results: The majority of cancers were found in the sigmoid colon. Total proctocolectomy was performed only in the UCCC group; however, half of the UCCC group underwent a standard operation. Five cases of postoperative complication occurred within six months in the UCCC group compared to one case in the SCC group. There was no significant difference in recurrence rate (p=0.361) or OS (p=0.896) between the arms. Conclusion: UCCC showed more postoperative complications than SCC, and equivalent oncology outcome, however the difference was not statistically significant. This study represents an experience of a single institution, thus further randomized studies are required to confirm.
शोध आलेख

PROCOLE (Prognostic Colorectal Leakage): A New Prognostic Index to Predict the Risk of Anastomotic Leak in Colorectal Cancer Surgery

Pina D, Simo R, Machado R, Sebastian A, Calpena R

Objective: To develop a prognostic index to predict the risk of developing anastomotic leakage after colorectal cancer surgery, this has been named PROCOLE (prognostic colorectal leakage). Methods: A systematic review of the literature of observational studies has been performed to identify risk factors and then, a meta-analysis of each factor has been done. The factors that are statistically significant are weighted according to the value of the effect size. The prognostic index has been validated by an observational, longitudinal, retrospective, case-control data collection. Results: The predictive ability of the PROCOLE is made from the data obtained from the sample of cases and controls, resulting in an area under the curve (AUC) of 0.82 with a confidence interval of 95% of the AUC [0.75, 0.89]. Conclusions: The PROCOLE score predicts the risk of developing anastomotic leakage and may be useful to assist operative decision-making such as the implementation of a protective stoma.
लघु संचार

Quick and Easy: Time to Integrate To Nest Test for Severity Assessment in a Murine Inflammatory Bowel Disease Model

Häger C, Keubler LM , Bleich A

Due to recent changes in EU regulations (2010/63/EU) as well as the general requirement to assess the condition of experimental laboratory animals, the development of innovative severity assessment strategies is required. In murine inflammatory bowel disease (IBD) models severity assessment is usually performed by clinical scoring, which is time consuming, stressful for the animals, and necessitates an experienced observer. This mini review looks at methods to identify disturbed animal welfare during experimental colitis by investigating changes in spontaneous animal behavior. We give a brief overview of the existing methods of severity assessment utilized in colitis models, focusing on a recently investigated method, the time to integrate to nest test (TINT). In a study investigating the course of colitis in genetically-susceptible and corresponding wild type mice, the suitability of TINT as a parameter of disturbed welfare was determined. TINT enabled the detection of mouse strain-related differences, but not dextran sulphate sodium (DSS) dose-dependent differences in colitis manifestation. Therefore, TINT may serve as an easily applicable indicator of disturbed animal welfare but cannot replace clinical investigation of animals under experimentation. The development of further severity assessment strategies that better mirror the actual condition of animals used in IBD studies is therefore vital.

शोध आलेख

Time Trend and Risk Factors of Initial Surgery for Crohn’s Disease in Japan

Yano Y, Matsui T, Matsusima Y, Takada Y, Kinjo K, et al.

Objective: It is unclear whether the initial surgical rate for CD in Japan has decreased. The present study investigated time trend of background factors and risk factors of initial surgery for CD patients. Methods: A total of 424 patients diagnosed with CD in our department over the last 20 years who had not undergone surgery were analyzed. The cumulative initial surgery rate was determined using the Kaplan-Meier method. Patients were analyzed to identify risk factors for initial intestinal surgery. Patients diagnosed between 1992 and 2001 were classified into the pre-biological era group (PRE) (n=248), and those diagnosed between 2002 and 2011 into the post-biological era group (POST) (n=176). The groups were compared regarding background factors and reason for initial surgery. Results: The patients included 303 men and 121 women and a mean length of follow-up of 5.5 ± 4.8 years. The comparison of background characteristics between the PRE group and the POST group for each factor demonstrated a significant increase in inflammatory Crohn’s disease in the POST group (47.6% vs. 61.9%; p=0.007). Cumulative initial surgery rates by era did not differ between the two groups, at 21.0% and 30.5% at 3 and 5 years, respectively, in the PRE group and 26.7% and 38.5% at 3 and 5 years, respectively, in the POST group. However, the surgery rate in patient with biologics treatment such as infliximab and adalimumab was significantly lower than that of patient without biologics at 5 year (8.6% vs. 37.9%; p

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