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논문 기본 정보

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저자정보
Eun Mi Song (Department of Gastroenterology University of Ulsan College of Medicine Korea) Jong Wook Kim (Department of Internal Medicine Inje University Ilsan Paik Hoipital Korea) Sun-Ho Lee (Department of Gastroenterology University of Ulsan College of Medicine Korea) Kiju Chang (Department of Gastroenterology University of Ulsan College of Medicine Korea) Sung Wook Hwang (Department of Gastroenterology University of Ulsan College of Medicine Korea) Sang Hyoung Park (Department of Gastroenterology Asan Medical Center University of Ulsan College of Medicine) Dong-Hoon Yang (Department of Gastroenterology University of Ulsan College of Medicine Seoul Korea) 정기욱 (Department of Gastroenterology University of Ulsan College of Medicine Seoul Korea) Byong Duk Ye (Department of Gastroenterology University of Ulsan College of Medicine Seoul Korea) Jeong-Sik Byeon (Department of Gastroenterology University of Ulsan College of Medicine Seoul Korea) Suk-Kyun Yang (Department of Gastroenterology Asan Medical Center University of Ulsan College of Medicine) Hyo Jeong Lee (Health Screening and Promotion Center Asan Medical Center Korea) Chang Sik Yu (Department of Colon and Rectal Surgery University of Ulsan College of Medicine Korea) Chan Wook Kim (Department of Colon and Rectal Surgery University of Ulsan College of Medicine Korea) Seong Ho Park (Department of Radiology University of Ulsan College of Medicine Korea) Jihun Kim (Department of Pathology University of Ulsan College of Medicine Korea) Seung-Jae Myung (Department of Gastroenterology University of Ulsan College of Medicine Korea)
저널정보
대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.25 No.1
발행연도
2019.1
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137 - 147 (11page)

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Background/Aims Previous studies from Korea have described chronic intestinal pseudo-obstruction (CIPO) patients with transition zone (TZ) in the colon. In this study, we evaluated the pathological characteristics and their association with long-term outcomes in Korean colonic pseudo-obstruction (CPO) patients with TZ. Methods We enrolled 39 CPO patients who were refractory to medical treatment and underwent colectomy between November 1989 and April 2016 (median age at symptoms onset: 45 [interquartile range, 29–57] years, males 46.2%). The TZ was defined as a colonic segment connecting a proximally dilated and distally non-dilated segment. Detailed pathologic analysis was performed. Results Among the 39 patients, 37 (94.9%) presented with TZ and 2 (5.1%) showed no definitive TZ. Median ganglion cell density in the TZ adjusted for the colonic circumference was significantly decreased compared to that in proximal dilated and distal non-dilated segments in TZ (+) patients (9.2 vs 254.3 and 150.5, P < 0.001). Among the TZ (+) patients, 6 showed additional pathologic findings including eosinophilic ganglionitis (n = 2), ulcers with combined cytomegalovirus infection (n = 2), diffuse ischemic changes (n = 1), and heterotropic myenteric plexus (n = 1). During follow-up (median, 61 months), 32 (82.1%) TZ (+) patients recovered without symptom recurrence after surgery. The presence of pathological features other than hypoganglionosis was an independent predictor of symptom recurrence after surgery (P = 0.046). Conclusions Hypoganglionosis can be identified in the TZ of most Korean CPO patients. Detection of other pathological features in addition to TZ-associated hypoganglionosis was associated with poor post-operative outcomes.
#Colonic pseudo-obstruction #Intestinal pseudo-obstruction #Pathology #Outcomes

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참고문헌 (29)

참고문헌 신청
Stanghellini V / 2005 / Natural history of chronic idiopathic intestinal pseudo-obstruction in adults : a single center study / Clin Gastroenterol Hepatol 3:449~458 google schola Lindberg G / 2009 / Clinical features and long-term survival in chronic intestinal pseudo-obstruction and enteric dysmotility / Scand J Gastroenterol 44:692~699 google schola Amiot A / 2009 / Long-term outcome of chronic intestinal pseudo-obstruction adult patients requiring home parenteral nutrition / Am J Gastroenterol 104:1262~1270 google schola Rosa-E-Silva L / 2006 / Clinical, radiologic, and manometric characteristics of chronic intestinal dysmotility : the Stanford experience / Clin Gastroenterol Hepatol 4:866~873 google schola Stanghellini V / 2007 / Chronic intestinal pseudo-obstruction : manifestations, natural history and management / Neurogastroenterol Motil 19:440~452 google schola

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