Clinical characteristics and prognosisof 273 Crohn'spatientswih gastrointestinal fistulas / 中国实用外科杂志

ABSTRACT

OBJECTIVE:To analyze the clinical characteristics and prognosis of Crohn's patients with gastrointestinal fistulas.METHODS:The data of 273 patients with gastrointestinal fistulas who were registered in GI Fistula Center, Department of Surgery, Jinling Hospital from January 2001 to June 2015 were retrospectively reviewed and the clinical features,characteristics of gastrointestinal fistulas, medication plan and outcome of the patients were analyzed.RESULTS:The ratio of male to female was 2.5:1.The mean onset age was 29(22,40)years. The mean diagnosis age was 31(25,42)years. The averageage between onset to diagnosis was22(8,31)months. The most common initial symptoms were abdominal pain(78.0%), diarrhea(28.9%) and fever(26.0%). The most common lesion locations were terminal ileum(56.8%). The most common behavior of disease were penetrating(54.9%), followed by stricturing(42.1%), inflammatory(2.9%) and perianal disease(19.0%). 442 patients developed GI, including intestinal cutaneous fistulas(73.9%) and intestinal fistulas(26.1%).The most type of intestinal cutaneousfistulas were ileocecal anastomotic fistula.The most type of intestinal fistulas were entero-vesical fistulas. Enteral nutrition(91.9%) and parenteralnutrition(72.9%) combined with sulfasalazine(57.9%) and tripterygium glycosides(48.0%) were the most commonly used drugs. A total of 227(83.1%)patientsreceived antibiotics due to infectious complications. Β-lactam(77.6%) and nitroimidazoles(56.0%) were the most common antibi-otics. All the patients had received 625 cases of operations. The cumulative operative rates of 1 year, 3 years and 5 years after diagnosis were 34.4%, 59.0%and 63.0%. 9(3.3%)patients died during the research.The cumulative survival rates were 98.5%, 97.8%,and 96.7% at 1 year, 3 years and 10 years after diagnosis.CONCLUSION:Compared with the literature of western and other Asian countries, there are some differences in sex ratio, lesion locations, operative rates and mortality ratesamong Crohn's disease patients with GI fistula. Further followup and in-depth study are needed.