BACKGROUND: In Crohn's disease natural history, about 80% of the patients require surgery, which is not curative: unfortunately, the disease recurs in many patients. OBJECTIVE: To investigate the role of intestinal ultrasound to predict the risk of post-operative surgical recurrence in Crohn's disease. MATERIAL AND METHODS: A total of 196 patients, with ileal or ileocolonic Crohn's disease, undergoing intestinal resection, were retrospectively enrolled. All patients underwent bowel ultrasonography 6-15 months after resection. Wall thickness at the anastomosis level was measured, and thickening >3 mm was evaluated as risk factor of long-term need for reoperation. RESULTS: Patients who have a bowel wall thickness >3 mm have an risk ratio (RR) of surgical recurrence = 2.1 [95% confidence interval (CI) = 1.12-3.74] higher than those with a thickness of ≤3 mm. The absolute incidence of new surgical intervention is 13% in patients with thickness of 3 mm, 28% in patients with thickness >3 mm, 29,1% with thickness >4 mm, 34% with thickness >5 mm, and 40% with thickness >6 mm. CONCLUSIONS: Bowel wall thickness >3 mm at ultrasound may be a non-invasive predictor of early surgical recurrence after ileo-colonic resection.
BACKGROUND: In Crohn's disease natural history, about 80% of the patients require surgery, which is not curative: unfortunately, the disease recurs in many patients. OBJECTIVE: To investigate the role of intestinal ultrasound to predict the risk of post-operative surgical recurrence in Crohn's disease. MATERIAL AND METHODS: A total of 196 patients, with ileal or ileocolonic Crohn's disease, undergoing intestinal resection, were retrospectively enrolled. All patients underwent bowel ultrasonography 6-15 months after resection. Wall thickness at the anastomosis level was measured, and thickening >3 mm was evaluated as risk factor of long-term need for reoperation. RESULTS:Patients who have a bowel wall thickness >3 mm have an risk ratio (RR) of surgical recurrence = 2.1 [95% confidence interval (CI) = 1.12-3.74] higher than those with a thickness of ≤3 mm. The absolute incidence of new surgical intervention is 13% in patients with thickness of 3 mm, 28% in patients with thickness >3 mm, 29,1% with thickness >4 mm, 34% with thickness >5 mm, and 40% with thickness >6 mm. CONCLUSIONS: Bowel wall thickness >3 mm at ultrasound may be a non-invasive predictor of early surgical recurrence after ileo-colonic resection.
Authors: Cláudia Patricia Macedo; Mara Sarmento Costa; Elisa Gravito-Soares; Marta Gravito-Soares; Ana Margarida Ferreira; Francisco Portela; Pedro Figueiredo Journal: GE Port J Gastroenterol Date: 2021-08-12
Authors: Lorenzo Bertani; Davide Giuseppe Ribaldone; Massimo Bellini; Maria Gloria Mumolo; Francesco Costa Journal: Nutrients Date: 2021-04-20 Impact factor: 5.717