Management and Long-term Outcomes of Crohn's Disease Complicated with Enterocutaneous Fistula: ECUFIT Study from GETECCU.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Barreiro-de Acosta Manuel, Riestra Sabino, Calafat Margalida, Soto María Pilar, Calvo Marta, Sánchez Rodríguez Eugenia, Caballol Berta, Vela Milagros, Rivero Montserrat, Muñoz Fernando, de Castro Luisa, Calvet Xavier, García-Alonso Francisco Javier, Utrilla Fornals Alejandra, Ferreiro-Iglesias Rocío, González-Muñoza Carlos, Chaparro María, Bujanda Luis, Sicilia Beatriz, Alfambra Erika, Rodríguez Andrés, Pérez Fernández Rubén, Rodríguez Cristina, Almela Pedro, Argüelles Federico, Busquets David, Tamarit-Sebastián Sonsoles, Reygosa Castro Cristina, Jiménez Laura, Marín-Jiménez Ignacio, Alcaide Noelia, Fernández-Salgado Estela, Iglesias Águeda, Ponferrada Ángel, Pajares Ramón, Roncero Óscar, Morales-Alvarado Víctor Jair, Ispízua-Madariaga Nahia, Sáinz Empar, Merino Olga, Márquez-Mosquera Lucía, García-Sepulcre Mariana, Elorza Ainara, Estrecha Sandra, Surís Gerard, Van Domselaar Manuel, Brotons Alicia, de Francisco Ruth, Cañete Fiorella, Iglesias Eva, Vera María Isabel, Mesonero Francisco, Lorente Rufo, Zabana Yamile, Cabriada José Luis, Domènech Eugeni, Rodríguez-Lago Iago
Аннотация
METHODS: Clinical information from all adult patients with CD and at least one ECF-excluding perianal fistulae-were identified from the prospectively-maintained ENEIDA registry. All additional information regarding treatment for this complication was retrospectively reviewed.
RESULTS: A total of 301 ECF in 286 patients [January 1970-September 2020] were analysed out of 30 088 records. These lesions were mostly located in the ileum [67%] and they had a median of one external opening [range 1-10]. After a median follow-up of 146 months (interquartile range [IQR], 69-233), 69% of patients underwent surgery. Fistula closure was achieved in 84%, mostly after surgery, and fistula recurrence was uncommon [13%]. Spontaneous and low-output fistulae were associated with higher closure rates (hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.17-1.93, p = 0.001, and HR 1.49, 95% CI 1.07-2.06, p = 0.03, respectively); this was obtained more frequently with medical therapy since biologics have been available.
CONCLUSIONS: ECF complicating CD are rare but entail a high burden of medical and surgical resources. Closure rates are high, usually after surgery, and fistula recurrence is uncommon. A significant proportion of patients receiving medical therapy can achieve fistula closure.