Prediction of surgical outcomes in severe encapsulating peritoneal sclerosis using a computed tomography scoring system
Background/Purpose: Encapsulating peritoneal sclerosis (EPS) is a rare and potential lethal complication of peritoneal dialysis characterized by bowel obstruction. Surgical enterolysis is the only curative therapy. Currently, there are no tools for predicting postsurgical prognosis. This study aimed...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664623002383 |
| _version_ | 1797348639908036608 |
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| author | Chih-Jung Wang Ying Jui Chao Yi-Sheng Liu Fan-Ting Liao Shen-Shin Chang Ting-Kai Liao Wei-Hsun Lu Ping-Jui Su Yan-Shen Shan |
| author_facet | Chih-Jung Wang Ying Jui Chao Yi-Sheng Liu Fan-Ting Liao Shen-Shin Chang Ting-Kai Liao Wei-Hsun Lu Ping-Jui Su Yan-Shen Shan |
| author_sort | Chih-Jung Wang |
| collection | DOAJ |
| description | Background/Purpose: Encapsulating peritoneal sclerosis (EPS) is a rare and potential lethal complication of peritoneal dialysis characterized by bowel obstruction. Surgical enterolysis is the only curative therapy. Currently, there are no tools for predicting postsurgical prognosis. This study aimed to identify a computed tomography (CT) scoring system that could predict mortality after surgery in patients with severe EPS. Methods: This retrospective study enrolled patients with severe EPS who underwent surgical enterolysis in a tertiary referral medical center. The association of CT score with surgical outcomes including mortality, blood loss, and bowel perforation was analyzed. Results: Thirty-four patients who underwent 37 procedures were recruited and divided into a survivor and non-survivor group. The survivor group had higher body mass indices (BMIs, 18.1 vs. 16.7 kg/m2, p = 0.035) and lower CT scores (11 vs. 17, p < 0.001) than the non-survivor group. The receiver operating characteristic curve revealed that a CT score of ≥15 could be considered a cutoff point to predict surgical mortality, with an area under the curve of 0.93, sensitivity of 88.9%, and specificity of 82.1%. Compared with the group with CT scores of <15, the group with CT scores of ≥15 had a lower BMI (19.7 vs. 16.2 kg/m2, p = 0.004), higher mortality (4.2% vs. 61.5%, p < 0.001), greater blood loss (50 vs. 400 mL, p = 0.007), and higher incidence of bowel perforation (12.5% vs. 61.5%, p = 0.006). Conclusion: The CT scoring system could be useful in predicting surgical risk in patients with severe EPS receiving enterolysis. |
| first_indexed | 2024-03-08T12:08:43Z |
| format | Article |
| id | doaj.art-730d6d46ed714bf18a2d39ef20505316 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-03-08T12:08:43Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-730d6d46ed714bf18a2d39ef205053162024-01-23T04:15:00ZengElsevierJournal of the Formosan Medical Association0929-66462024-01-01123198105Prediction of surgical outcomes in severe encapsulating peritoneal sclerosis using a computed tomography scoring systemChih-Jung Wang0Ying Jui Chao1Yi-Sheng Liu2Fan-Ting Liao3Shen-Shin Chang4Ting-Kai Liao5Wei-Hsun Lu6Ping-Jui Su7Yan-Shen Shan8Division of Trauma, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, TaiwanDivision of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, TaiwanDepartment of Radiology, National Cheng Kung University Hospital, Tainan, TaiwanDivision of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, TaiwanDivision of Transplantation, Department of Surgery, National Cheng Kung University Hospital, Tainan, TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, TaiwanDivision of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan; Corresponding author. Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, and Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, Taiwan. Fax: +886 6 276 6676.Background/Purpose: Encapsulating peritoneal sclerosis (EPS) is a rare and potential lethal complication of peritoneal dialysis characterized by bowel obstruction. Surgical enterolysis is the only curative therapy. Currently, there are no tools for predicting postsurgical prognosis. This study aimed to identify a computed tomography (CT) scoring system that could predict mortality after surgery in patients with severe EPS. Methods: This retrospective study enrolled patients with severe EPS who underwent surgical enterolysis in a tertiary referral medical center. The association of CT score with surgical outcomes including mortality, blood loss, and bowel perforation was analyzed. Results: Thirty-four patients who underwent 37 procedures were recruited and divided into a survivor and non-survivor group. The survivor group had higher body mass indices (BMIs, 18.1 vs. 16.7 kg/m2, p = 0.035) and lower CT scores (11 vs. 17, p < 0.001) than the non-survivor group. The receiver operating characteristic curve revealed that a CT score of ≥15 could be considered a cutoff point to predict surgical mortality, with an area under the curve of 0.93, sensitivity of 88.9%, and specificity of 82.1%. Compared with the group with CT scores of <15, the group with CT scores of ≥15 had a lower BMI (19.7 vs. 16.2 kg/m2, p = 0.004), higher mortality (4.2% vs. 61.5%, p < 0.001), greater blood loss (50 vs. 400 mL, p = 0.007), and higher incidence of bowel perforation (12.5% vs. 61.5%, p = 0.006). Conclusion: The CT scoring system could be useful in predicting surgical risk in patients with severe EPS receiving enterolysis.http://www.sciencedirect.com/science/article/pii/S0929664623002383Computed tomographyEnterolysisSurgical riskEncapsulating peritoneal sclerosisDialysis |
| spellingShingle | Chih-Jung Wang Ying Jui Chao Yi-Sheng Liu Fan-Ting Liao Shen-Shin Chang Ting-Kai Liao Wei-Hsun Lu Ping-Jui Su Yan-Shen Shan Prediction of surgical outcomes in severe encapsulating peritoneal sclerosis using a computed tomography scoring system Journal of the Formosan Medical Association Computed tomography Enterolysis Surgical risk Encapsulating peritoneal sclerosis Dialysis |
| title | Prediction of surgical outcomes in severe encapsulating peritoneal sclerosis using a computed tomography scoring system |
| title_full | Prediction of surgical outcomes in severe encapsulating peritoneal sclerosis using a computed tomography scoring system |
| title_fullStr | Prediction of surgical outcomes in severe encapsulating peritoneal sclerosis using a computed tomography scoring system |
| title_full_unstemmed | Prediction of surgical outcomes in severe encapsulating peritoneal sclerosis using a computed tomography scoring system |
| title_short | Prediction of surgical outcomes in severe encapsulating peritoneal sclerosis using a computed tomography scoring system |
| title_sort | prediction of surgical outcomes in severe encapsulating peritoneal sclerosis using a computed tomography scoring system |
| topic | Computed tomography Enterolysis Surgical risk Encapsulating peritoneal sclerosis Dialysis |
| url | http://www.sciencedirect.com/science/article/pii/S0929664623002383 |
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