Lefevre_2011

Referenz

(Autor, Jahr, Journal)

Studientyp

Mono- vs. Multizentrisch, Verblindung, Randomisierung, Arme, Fallzahl n, Land, Zeitraum

Patienten-merkmale

Indikation, Alter, Geschlecht (m/w)

Intervention

Fallzahl n, Beschreibung der präventiven bzw. therapeutischen Maßnahme

Kontrolle

Fallzahl n, Beschreibung der präventiven Maßnahme bzw. therapeutischen Maßnahme

Zielgrößen

Primärer Endpunkt

Sekundäre(r) Endpunkt(e)

Primärer Endpunkt

Angaben für Intervention vs. Kontrolle

Sekundäre(r) Endpunkt(e)

Angaben für Intervention vs. Kontrolle

Finanzierung

Evidenzstufe

Bei Abwertung: Angabe von Gründen

Bewertung des Autors

Lefevre

2011

British Journal of Surgery

Retrospective study

n = 107

France

01/1980 – 04/2009

chronic radiation enteritis (CRE)

women: 94 (87.9 %)

radiotherapy (RT) for gynaecological or digestive carcinoma: 89 pts (83.2 %)

postoperative RT: 98 pts (91.6 %)

median radiation dose:  50 (40–115)

Gy.

first symptom of CRE: median of 11 (1–347) months after radiotherapy.

surgery for CRE - extensive small bowel resection

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outcome after surgery for CRE

Postoperative morbidity and mortality, reoperation for recurrent enteritis and risk factors for reoperation

Main indication for surgery: symptomatic stricture (82 pts; 76.6 %).

Ileocaecal resections: 49 (45.8 %)

Overall morbidity: 74.8 % (80

pts)

surgical morbidity rates: 28.0 % (30 pts)

reoperation for complications: 14 pts (13.1 %)

Reoperation rates for CRE

1 years of follow-up: 37 %

3 years of follow-up: 54 %

Risk factors for reoperation for recurrent enteritis

emergency surgery (odds ratio (OR) 2.72, 95 % KI: 1.57 to 4.86), anastomotic leakage (OR 2.53, 1.54 to 4.42) and male sex (OR 3.57, 1.82 to 7.29).

protective factor for reoperation

ileocaecal resection during the first surgical procedure (OR 4.48, 2.52 to 8.31)

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4

"Ileocaecal resection was the only factor that protected against reoperation for recurrent CRE, demonstrating the importance of resecting all damaged tissue in these patients. These results suggest that there is little place for intestinal bypass surgery or adhesiolysis."