粘膜相关淋巴组织手术可能导致炎症性肠病:系统回顾与元分析》。

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY Gastroenterology Research Pub Date : 2024-04-01 Epub Date: 2024-04-30 DOI:10.14740/gr1672
Rutvi Amin, Aditya Mansabdar, Hyundam Gu, Bhavani Gangineni, Neev Mehta, Harini Patel, Neel Patel, Srishti Laller, Suprada Vinayak, Mohammed Ali Abdulqader, Hardik Jain, Amitjeet Singh Rekhraj, Harshini Adimoulame, Gurinder Singh, Jose Moonjely Davis, Urvish Patel, Harmeet Gill
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引用次数: 0

摘要

背景:炎症性肠病(IBD)是由遗传易感性和环境因素引起的一组慢性炎症性胃肠道疾病,影响着全球相当一部分人口。众所周知,肠道相关淋巴组织(GALT)在免疫调节和维持肠道微生物群平衡方面发挥着至关重要的作用。众所周知,后者的菌群失调与肠道疾病有关。因此,随着儿童腺样体切除术的日益普遍,应探讨其与 IBD 的潜在联系。本文旨在评估腺样体组织切除与克罗恩病(CD)和溃疡性结肠炎(UC)发病风险之间的关系:我们进行了一项汇总荟萃分析,以评估接受阑尾切除术和扁桃体切除术的患者与未接受阑尾切除术和扁桃体切除术的患者相比所获得的更多临床结果。我们在PubMed数据库中系统搜索了相关的英文观察性研究。我们遵循流行病学观察性研究元分析(MOOSE)指南,收集不同时期的数据,并处理研究结果的多样性;我们采用了考虑异质性的随机效应分析。对于结果,采用随机效应模型对几率比(ORs)进行汇总:在总共 114,537 项研究中,有 7 项研究符合我们的纳入标准。我们的荟萃分析表明,阑尾切除术与 CD 有显著相关性(OR:1.57;95% 置信区间 (CI):1.01 - 2.43;异质性 I2 = 93%)。同样,我们还发现扁桃体切除术与 CD 有显著相关性(OR:1.93;95% CI:0.96 - 3.89;I2 = 62%)。然而,在阑尾切除术与 UC 之间未观察到明显的关联(OR:0.60;95% CI:0.24 - 1.47;I2 = 96%),而在扁桃体切除术与 UC 之间发现了适度的关联(OR:1.24;95% CI:1.18 - 1.30;I2 = 0%):总之,我们发现阑尾切除术的趋势与较高的 CD 发生几率有关,而扁桃体切除术更有可能与 CD 和 UC 发生几率的增加有关,但存在偏倚风险。
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Mucosa-Associated Lymphoid Tissue Surgeries as a Possible Risk for Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.

Background: Inflammatory bowel disease (IBD) is a group of chronic inflammatory gastrointestinal disorders that are caused by genetic susceptibility and environmental factors and affects a significant portion of the global population. The gut-associated lymphoid tissue (GALT) is known to play a crucial role in immune modulation and maintaining gut microbiota balance. Dysbiosis in the latter has a known link to IBD. Therefore, the increasing prevalence of adenoidectomy in children should be explored for its potential association with IBD. The objective of this paper was to assess the association between adenoid tissue removal and the risk of developing Crohn's disease (CD) and ulcerative colitis (UC).

Methods: We conducted a pooled meta-analysis to evaluate the extended clinical outcomes in patients who underwent appendicectomy and tonsillectomy compared to those who did not. Our approach involved systematically searching the PubMed database for relevant observational studies written in English. We followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines to collect data from various time periods, and to address the diversity in study results; we employed a random-effects analysis that considered heterogeneity. For outcomes, odds ratios (ORs) were pooled using a random-effects model.

Results: Seven studies, out of a total of 114,537, met our inclusion criteria. Our meta-analysis revealed a significant association between appendicectomy and CD (OR: 1.57; 95% confidence interval (CI): 1.01 - 2.43; heterogeneity I2 = 93%). Similarly, we found a significant association between tonsillectomy and CD (OR: 1.93; 95% CI: 0.96 - 3.89; I2 = 62%). However, no significant association was observed between appendicectomy and UC (OR: 0.60; 95% CI: 0.24 - 1.47; I2 = 96%), while a modest association was found between tonsillectomy and UC (OR: 1.24; 95% CI: 1.18 - 1.30; I2 = 0%).

Conclusions: In summary, we found that the trend of appendicectomy is linked to higher odds of CD, and tonsillectomy is more likely associated with increased odds for both CD and UC, with a risk of bias present.

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Gastroenterology Research
Gastroenterology Research GASTROENTEROLOGY & HEPATOLOGY-
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