Background and Objectives: The goal of this study was to compare disease-specific risk factors and 30-day outcomes between patients with Crohn’s disease (CD) and colon cancer (CC) undergoing right-sided surgical resection. Methods: The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP^®) was interrogated to extract all patients ≥18 years undergoing elective right-sided resection for CD versus CC. Independent risk factors for surgical complications were identified through multivariable logistic regression for both groups. In a second step, surgical and medical 30-day morbidity was compared after risk adjustment. Results: The cohort consisted of 17,516 patients, of which 2,899 (16.6%) underwent surgery for CD versus 14,617 (83.4%) for CC. Independent risk factors for surgical complications in patients with CD were male gender, African American race, ASA score (III or IV), active smoking, prolonged surgery, and preoperative anemia. Independent risk factors for surgical complications in the cancer group were age ≥70 years, male gender, ASA score (III or IV), respiratory and cardiovascular comorbidities, and preoperative hypoalbuminemia (#x3c;3.5 g/dL). After risk adjustment, surgical complications (OR 1.25, p = 0.002), sepsis (OR 1.64, p = 0.012), and unplanned readmissions (OR 1.39, p = 0.004) were more common in patients with CD. Thirty-day mortality was higher in cancer patients (1.1 vs. 0.1%, p #x3c; 0.0001). Conclusions: Patients with Crohn’s disease were more prone to surgical complications and postoperative sepsis compared to the cancer group undergoing the same procedure. Careful evaluation and correction of disease-specific modifiable risk factors of patients with CD and CC, respectively, are important.
Dig Surg

中文翻译：

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克罗恩病和癌症的手术切除：疾病特异性危险因素和结果的比较

背景和目的：本研究的目的是比较克罗恩病 (CD) 和结肠癌 (CC) 患者进行右侧手术切除的疾病特异性危险因素和 30 天结果。方法：外科医生，全国外科质量改进计划（ACS-NSQIP美国学院^®）被审问提取所有患者≥18岁择期右路切除CD与CC。通过多变量逻辑回归确定两组手术并发症的独立危险因素。第二步，在风险调整后比较手术和医疗 30 天的发病率。结果：该队列包括 17,516 名患者，其中 2,899 (16.6%) 名因 CD 接受手术，14,617 (83.4%) 名因 CC 接受手术。CD 患者手术并发症的独立危险因素是男性、非裔美国人、ASA 评分（III 或 IV）、主动吸烟、手术时间延长和术前贫血。癌症组手术并发症的独立危险因素是年龄≥70 岁、男性、ASA 评分（III 或 IV）、呼吸和心血管合并症以及术前低白蛋白血症（#x3c；3.5 g/dL）。风险调整后，手术并发症（OR 1.25，p = 0.002）、败血症（OR 1.64，p = 0.012）和意外再入院（OR 1.39，p= 0.004) 在 CD 患者中更为常见。癌症患者的 30 天死亡率较高（1.1 与 0.1%，p #x3c；0.0001）。结论：与接受相同手术的癌症组相比，克罗恩病患者更容易出现手术并发症和术后败血症。分别对 CD 和 CC 患者的疾病特异性可改变危险因素进行仔细评估和纠正非常重要。
挖掘手术