Iuliana D Bobanga1, Shiyu Bai2, Marco A Swanson2, Bradley J Champagne2, Harry J Reynolds2, Conor P Delaney2, Edward M Barksdale2, Sharon L Stein2. 1. Division of Colon and Rectal Surgery, Department of Surgery, Case Western/University Hospital Case Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH 44106, USA. Electronic address: iuliana.bobanga@uhhospitals.org. 2. Division of Colon and Rectal Surgery, Department of Surgery, Case Western/University Hospital Case Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH 44106, USA.
Abstract
BACKGROUND: Factors influencing recurrence of ileocecal Crohn's disease (CD) after surgical resection may differ between adolescents and adults. METHODS: CD patients who underwent ileocecectomy were retrospectively divided into pediatric onset (age at diagnosis ≤ 16 years, n = 34) and adult onset (>16, n = 108) patients to evaluate differences in risks of endoscopic and clinical recurrence. RESULTS: In 142 patients, rates of any recurrence, endoscopic recurrence, and clinical recurrence at 5 years were 78%, 88%, and 65%, respectively. Risks of recurrence were similar between groups. Younger patients were more likely to be on immunologics preoperatively and more likely to be started on immunoprophylaxis postoperatively. Immediate postoperative prophylaxis was predictive of delayed clinical recurrence only in the older group. CONCLUSIONS: Despite increased preoperative and postoperative immunoprophylaxis in younger patients, recurrence rates of CD after ileocecectomy do not differ between these groups. Immediate postoperative prophylaxis was predictive of delayed clinical recurrence only in patients with adult onset CD.
BACKGROUND: Factors influencing recurrence of ileocecal Crohn's disease (CD) after surgical resection may differ between adolescents and adults. METHODS:CDpatients who underwent ileocecectomy were retrospectively divided into pediatric onset (age at diagnosis ≤ 16 years, n = 34) and adult onset (>16, n = 108) patients to evaluate differences in risks of endoscopic and clinical recurrence. RESULTS: In 142 patients, rates of any recurrence, endoscopic recurrence, and clinical recurrence at 5 years were 78%, 88%, and 65%, respectively. Risks of recurrence were similar between groups. Younger patients were more likely to be on immunologics preoperatively and more likely to be started on immunoprophylaxis postoperatively. Immediate postoperative prophylaxis was predictive of delayed clinical recurrence only in the older group. CONCLUSIONS: Despite increased preoperative and postoperative immunoprophylaxis in younger patients, recurrence rates of CD after ileocecectomy do not differ between these groups. Immediate postoperative prophylaxis was predictive of delayed clinical recurrence only in patients with adult onset CD.
Authors: Francesco Tonelli; Giovanni Alemanno; Carmela Di Martino; Adriana Focardi; Giorgio Gronchi; Francesco Giudici Journal: Langenbecks Arch Surg Date: 2016-08-17 Impact factor: 3.445
Authors: Kristyna Zarubova; Ondrej Fabian; Ondrej Hradsky; Tereza Lerchova; Filip Mikus; Vojtech Dotlacil; Lucie Pos; Richard Skaba; Jiri Bronsky Journal: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Date: 2021-08-24 Impact factor: 1.648