Langenbeck's archives of surgery · 2025
Shorter time to infection control predicts spontaneous closure of small intestinal fistulas after emergency abdominal procedures.
СтатьяНазвание и аннотация: Перевод в очереди
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Hu Jiangping, Wen Hui, Jing Hailing, Gong Xiaosong, Huang Ming, Zhao Risheng, Yao Zheng, Li Linpeng
Аннотация
OBJECTIVE: This study aimed to investigate the impact of abdominal infection control duration on the spontaneous closure (SC) of small intestinal fistula (SIF) following emergency abdominal procedure.
METHODS: A retrospective cohort study was conducted on 153 patients from November 2022 to November 2024. The primary outcome was SC. The duration required to achieve infection control was evaluated as a potential factor associated with SC.
RESULTS: Among 153 included patients (median age 48 years, 57.5% male), 60 (39.2%) achieved spontaneous closure (SC) during pre-definitive surgery treatment. The median time to infection control was 28 days overall and 25 days for those achieving SC. Segmented analysis identified 33 days as the optimal cutoff for early versus delayed source control. Early source control (≤33 days) was associated SC (adjusted OR=3.41, 95% CI: 1.36-8.56, P=0.009). Of patients achieving SC, 44 (73.3%) did so within 30 days post-source control. Restricted cubic spline analysis suggested 26 days as a threshold for infection control duration influencing SC within 30 days. Source control duration <26 days was associated with increased likelihood of SC within 30 days (adjusted OR=2.58, 95% CI: 1.23-5.39, P=0.012).
CONCLUSION: The duration required to achieve infection control was associated with SC of SIF following emergency abdominal procedure.
METHODS: A retrospective cohort study was conducted on 153 patients from November 2022 to November 2024. The primary outcome was SC. The duration required to achieve infection control was evaluated as a potential factor associated with SC.
RESULTS: Among 153 included patients (median age 48 years, 57.5% male), 60 (39.2%) achieved spontaneous closure (SC) during pre-definitive surgery treatment. The median time to infection control was 28 days overall and 25 days for those achieving SC. Segmented analysis identified 33 days as the optimal cutoff for early versus delayed source control. Early source control (≤33 days) was associated SC (adjusted OR=3.41, 95% CI: 1.36-8.56, P=0.009). Of patients achieving SC, 44 (73.3%) did so within 30 days post-source control. Restricted cubic spline analysis suggested 26 days as a threshold for infection control duration influencing SC within 30 days. Source control duration <26 days was associated with increased likelihood of SC within 30 days (adjusted OR=2.58, 95% CI: 1.23-5.39, P=0.012).
CONCLUSION: The duration required to achieve infection control was associated with SC of SIF following emergency abdominal procedure.