크론병과 연관된 복강 내 농양에서 비수술 치료의 효용성

Abstract

Background/Aims: This study was conducted to compare the clinical efficacy between surgical and nonsurgical treatments for patients with Crohn`s disease-related intraabdominal abscess. Methods: A retrospective review of medical records was performed for patients admitted to a single institution due to Crohn`s disease-related intra-abdominal abscess from February, 1996 to February, 2008. Clinical outcomes were compared between surgical and nonsurgical groups in terms of treatment responses and recurrences. Results: A total of 47 episodes of intra-abdominal abscesses in 43 patients (12.7%) were identified from 339 patients with Crohn`s disease. Of these, initially, 18 cases (38.3%) underwent surgical treatment and 29 (61.7%) were treated medically (antibiotic treatments with or without percutaneous drainage). The overall treatment response rates of surgical and nonsurgical group were 100% versus 89.7% (p=0.11) and recurrence rates were 27.8% versus 30.8% (p=1.00). Three patients in nonsurgical group (10.3%) showed no response to therapy and ultimately received surgical drainages. The median length of hospitalization in nonsurgical group was shorter than in surgical group (12 and 29.5 days, respectively. p=0.02). Conclusions: Nonsurgical treatment might be as effective as surgical treatment for the treatment of Crohn`s disease-related intraabdominal abscess, especially considering shorter hospital stay