Updating predictors of endoscopic recurrence after ileocolic resection for Crohn disease.
نویسندگان
چکیده
BACKGROUND/AIMS Identifying predictors of endoscopic recurrence (ER) has become very important to guide the decision of postoperative strategy. This study aimed to determine the rate of endoscopic recurrence until 12 months after ileocolic resection for Crohn disease (CD) in a cohort and identify its possible predictors. MATERIALS AND METHODS We conducted a retrospective single-center study that included patients with CD who underwent ileocolic resection between 2003 and 2014. ER was defined according to the Rutgeerts' score, defined as i2, i3, or i4 at ileocolonoscopy that was performed 6-12 months after surgery. The patients were classified into two groups according to the Rutgeerts´ score: non-ER (Rutgeerts i0/i1) and ER (Rutgeerts ≥i2). Multivariate logistic regression analysis was performed, including significant variables on univariable analysis, to identify ER predictors. RESULTS Forty-two patients were included. The mean period of the first postoperative colonoscopy was 9 months, and ER was observed in 25 patients (59.5%). The perianal disease and shorter duration of CD were the only ER predictors (p=0.024; OR, 8.36; 95% CI, 1.329-52.642 and p=0.039; OR, 0.965; 95% CI, 0.933-0.998, respectively). CONCLUSION Endoscopic recurrence affects almost two-thirds of patients with CD after ileocolic resection, with perianal involvement and a shorter duration of disease being significant risk factors. These factors may indicate a more aggressive disease associated with rapid progression and support the need of intensive early treatment to improve patients' outcomes.
منابع مشابه
Predictive factors for endoscopic recurrence after ileocolic resection for Crohn's disease.
lators and biologic agents, approximately 70%-80% of patients with Crohn’s disease (CD) undergo surgical resection and up to 70% of these require a second operation due to continuing inflammation (1). Therefore, postoperative recurrence (POR) still remains a crucial issue. The mechanism of POR is not exactly known, but it may be mediated by luminal contents. POR can be determined and measured c...
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PURPOSE Several studies have compared conventional open ileocolic resection with a laparoscopic-assisted approach. However, long-term outcome after laparoscopic-assisted ileocolic resection remains to be determined. This study was designed to compare long-term results of surgical recurrence, quality of life, body image, and cosmesis in patients who underwent laparoscopic-assisted or open ileoco...
متن کاملNatural course of Crohn's disease after ileocolic resection: endoscopically visualised ileal ulcers preceding symptoms.
Forty two Crohn's disease patients were followed up after ileocolic resection with regard to symptoms and endoscopic appearance of the ileocolic anastomosis. Twenty eight patients resected because of colonic neoplasm served as controls. In all the Crohn's disease patients the ileal resection margin was disease free macroscopically at operation. In addition, intraoperative ileoscopy was performe...
متن کاملTOPIC HIGHLIGHT Risk of postoperative recurrence and postoperative management of Crohn’s disease
Crohn’s disease (CD) is a chronic inflammatory disease of the digestive tract with systemic manifestations. Etiology is unknown, even if immunological, genetic and environmental factors are involved. The majority of CD patients require surgery during their lifetime due to progressive bowel damage, but, even when all macroscopic lesions have been removed by surgery, the disease recurs in most ca...
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عنوان ژورنال:
- The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology
دوره 28 4 شماره
صفحات -
تاریخ انتشار 2017