Should enteric fistulas from Crohn's disease or diverticulitis be treated laparoscopically or by open surgery?
Bibliographic record
Abstract
PURPOSE: The aim of this study was to study a group of consecutive patients with enteric fistulas treated by laparoscopic surgery and to compare outcomes with a matched group of patients treated by open surgery. METHODS: The outcomes of 13 patients with Crohn's disease or sigmoid diverticulitis with enteric fistulas treated laparoscopically (Group I) were compared with 13 patients matched for age, weight, gender, diagnosis, and characteristics of fistulas and treated by conventional surgery (Group II) during the same period. RESULTS: No patient died postoperatively in either group. Mean operative time was 183 minutes in Group I vs. 154 minutes in Group II (P = 0.280). No significant difference was found between Groups I and II in the number of patients with major postoperative complications (3 vs. 5; P = 0.462), or postoperative stay (7.6 +/- 3.6 vs. 9.2 +/- 3 days; P = 0.239). Conversion to open laparotomy occurred in one (7.7 percent) patient from Group I. No patient required readmission for secondary surgery in Group I, and two patients were readmitted and underwent reoperation for complications in Group II (P = 0.462). CONCLUSIONS: The laparoscopic treatment of selected cases of enteric fistulas is safe. Although most good outcome trends favor the laparoscopic group, the study is inconclusive, because no statistical difference was demonstrated with regard to operative time, number of postoperative complications, readmission rate, and length of postoperative stay, most likely because of the small number of cases in each arm of the study. Study of a greater number of cases outside the learning curve of the laparoscopic surgeons would clarify this issue. Other outcomes, including cost, pain control, cosmesis, and return to activities of daily living, need to be included in the evaluation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".