Accuratedefinitionandmanagementofidiopathicsclerosingencapsulatingperitonitis

摘要： AIM:Toreviewtheliteratureonidiopathicsclerosingencapsulatingperitonitis(SEP),alsoknownasabdominalcocoonsyndrome.METHODS:ThePubMed,MEDLINE,GoogleScholar,andGoogledatabasesweresearchedusingspecifickeywordstoidentifyarticlesrelatedtoidiopathicSEP.Thesekeywordsweresclerosingencapsulatingperitonitis,idiopathicsclerosingencapsulatingperitonitis,abdominalcocoon,andabdominalcocoonsyndrome.Thesearchincludedletterstotheeditor,casereports,reviewarticles,originalarticles,andmeetingpresentationspublishedintheEnglish-languageliteraturefromJanuary2000toMay2014.Articlesorabstractscontainingadequateinformationaboutage,sex,symptomduration,initialdiagnosis,radiologicaltools,andsurgicalapproacheswereincludedinthestudy.Paperswithmissingorinadequatedatawereexcluded.RESULTS:Theliteraturesearchyielded73articlesonidiopathic(primary)SEPpublishedin23countries.ThefourcountriesthatpublishedthegreatestnumberofarticleswereIndia(n=21),Turkey(n=14),China(n=8)andNigeria(n=3).ThefourcountriesthatreportedthegreatestnumberofcaseswereChina(n=104;53.88%),India(n=35;18.13%),Turkey(n=17;8.80%)andNigeria(n=5;2.59%).Thepresentstudyincluded193patients.Dataonagecouldbeobtainedfor184patients(range:7-87years;mean±SD,34.7±19.2years),butwereunavailableforninepatients.Ofthe184patients,122weremaleand62werefemale;sexdatacouldnotbeaccessedintheremainingninepatients.Ofthe149patientswhosepreoperativediagnosisinformationcouldbeobtained,65(43.6%)underwentoperationsforabdominalcocoon,whilethemajorityoftheremainingpatientsunderwentoperationsforapresumeddiagnosisofintestinalobstructionand/orabdominalmass.Managementinformationcouldberetrievedfor115patients.Ofthese,68underwentexcision+adhesiolysis(onelaparoscopic);24underwentprophylacticappendectomyinadditiontoexcision+adhesiolysis.Twentypatientsunderwentvariousresectionandrepairtechniquesalongwithexcision+adhesiolysis.Theremainingthreepatientsweremanagedwithantituberculosistherapy(n=2)andimmunosuppressivetherapy(n=1).CONCLUSION:IdiopathicSEPisararedisordercharacterizedbyfrequentlyrecurringboutsofintestinalobstruction.Surgicaltherapyisthegoldstandardmanagementstrategy. （共13頁）