ナガタ　サトル   Nagata Satoru   永田　智    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Immunosuppressive medication is not associated with surgical site infection after surgery for intractable ulcerative colitis in children.
掲載誌名	正式名：Intractable & rare diseases research 略　 称：Intractable Rare Dis Res ISSNコード：21863644/21863644
掲載区分	国外
巻・号・頁	6(2),pp.106-113
著者・共著者	Uchida Keiichi, Ohtsuka Yoshikazu, Yoden Atsushi, Tajiri Hitoshi, Kimura Hideaki, Isihige Takashi, Yamada Hiroyuki, Arai Katsuhiro, Tomomasa Takeshi, Ushijima Kosuke, Aomatsu Tomoki, Nagata Satoru, Otake Kohei, Matsushita Kohei, Inoue Mikihiro, Kudo Takahiro, Hosoi Kenji, Takeuchi Kazuo, Shimizu Toshiaki
発行年月	2017/05
概要	Pediatric ulcerative colitis (UC) sometimes progresses to an intractable condition for medical therapy. The surgical management of UC is challenging because of difficult procedures and frequent infectious complications. The aim of this study was to survey surgical procedures and infectious complications in pediatric patients with UC in Japan and to assess the relationship between preoperatively administered immunosuppressive drugs and postoperative surgical site infection (SSI). A survey of pediatric patients treated from 2000 to 2012 was sent to 683 facilities nationwide. Secondary questionnaires were sent to physicians who followed up patients with UC who had undergone surgery with the aim of assessing the relationships between postoperative SSI and selected preoperative patient characteristics, disease severity, medications, and operative procedures. Data for 136 patients (77 boys and 59 girls) were assessed. Median age at surgery was 14.1 years (range: 2.4-18.9 years). Surgery was performed in one stage in 35 cases, two stages in 57 cases, and three stages in 44 cases. SSI occurred in 36/136 patients (26%). According to multiple logistic regression analysis, there were statistically significant associations between SSI and staged surgery (three/one, OR: 6.7, 95% CI: 2.1-25.5, p = 0.0007; three/two, OR: 3.4, 95% CI: 1.4-8.6, p = 0.0069) and female sex (OR: 2.3, 95% CI: 1.0-5.4, p = 0.0434). Preoperative medications and incidence of SSI were not significantly associated. Preoperative immunosuppressive medication does not affect the incidence of SSI. Three-stage surgery and female sex are independent predictors of development of postoperative SSIs in pediatric patients with UC.
DOI	10.5582/irdr.2017.01012
PMID	28580210