Rosario Fornaro1, Elisa Caratto2, Michela Caratto2, Francesco Fornaro2, Giuseppe Caristo2, Marco Frascio2, Camilla Sticchi3. 1. University of Genoa, Department of Surgery, IRCCS San Martino Hospital IST, Largo Rosanna Benzi n 10, 16132 Genova, Italy. Electronic address: rfornaro@unige.it. 2. University of Genoa, Department of Surgery, IRCCS San Martino Hospital IST, Largo Rosanna Benzi n 10, 16132 Genova, Italy. 3. ARS - Agenzia Regionale Sanitaria, Liguria - Area Epidemiologia e Prevenzione, Piazza della Vittoria n 15, 16121 Genova, Italy.
Abstract
INTRODUCTION: Crohn's disease is associated with high rates of postoperative recurrence. At 10 years after surgery a high percentage of patients suffer recurrence (as many as 75% and above) and many of these (up to 45%) require re-intervention. The aim of the study was to identify, amongst the various "potential predictive factors", those which today should be considered "real risk factors" for postoperative recurrence. METHODS: A review of literature of the last 30 years was carried out. A medical literature search was conducted using Medline, Embase, Ovid Journals, Science Direct, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews. Potential risk factors related to the patient, disease, type of surgery and pharmacological treatment were analyzed. RESULTS: According to most Authors predictive factors, in addition to smoke, are also represented by an extent of disease superior to 100 cm and by absence of postoperative pharmacological treatment. Moreover, according to "the second European evidence-based Consensus on the diagnosis and the management of Crohn's disease: Special situations", localization of disease in the colon, penetrative behavior of disease, extensive small bowel resection and prior intestinal surgery should also be considered predictive factors. CONCLUSIONS: The high incidence of postoperative recurrence in Crohn's disease mandates a strict follow up (clinical, laboratory and instrumental monitoring). Identifying patients with increased risk would enable physicians to plan a surveillance program and to implement a rational therapeutic prophylaxis.
INTRODUCTION:Crohn's disease is associated with high rates of postoperative recurrence. At 10 years after surgery a high percentage of patients suffer recurrence (as many as 75% and above) and many of these (up to 45%) require re-intervention. The aim of the study was to identify, amongst the various "potential predictive factors", those which today should be considered "real risk factors" for postoperative recurrence. METHODS: A review of literature of the last 30 years was carried out. A medical literature search was conducted using Medline, Embase, Ovid Journals, Science Direct, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews. Potential risk factors related to the patient, disease, type of surgery and pharmacological treatment were analyzed. RESULTS: According to most Authors predictive factors, in addition to smoke, are also represented by an extent of disease superior to 100 cm and by absence of postoperative pharmacological treatment. Moreover, according to "the second European evidence-based Consensus on the diagnosis and the management of Crohn's disease: Special situations", localization of disease in the colon, penetrative behavior of disease, extensive small bowel resection and prior intestinal surgery should also be considered predictive factors. CONCLUSIONS: The high incidence of postoperative recurrence in Crohn's disease mandates a strict follow up (clinical, laboratory and instrumental monitoring). Identifying patients with increased risk would enable physicians to plan a surveillance program and to implement a rational therapeutic prophylaxis.
Authors: Jae Jun Park; Suk-Kyun Yang; Byong Duk Ye; Jong Wook Kim; Dong Il Park; Hyuk Yoon; Jong Pil Im; Kang Moon Lee; Sang Nam Yoon; Heeyoung Lee Journal: Intest Res Date: 2017-01-31
Authors: Calvin J Coffey; Miranda G Kiernan; Shaheel M Sahebally; Awad Jarrar; John P Burke; Patrick A Kiely; Bo Shen; David Waldron; Colin Peirce; Manus Moloney; Maeve Skelly; Paul Tibbitts; Hena Hidayat; Peter N Faul; Vourneen Healy; Peter D O'Leary; Leon G Walsh; Peter Dockery; Ronan P O'Connell; Sean T Martin; Fergus Shanahan; Claudio Fiocchi; Colum P Dunne Journal: J Crohns Colitis Date: 2018-11-09 Impact factor: 9.071
Authors: S Ingallinella; M Campanelli; A Antonelli; C Arcudi; V Bellato; A Divizia; M Franceschilli; L Petagna; B Sensi; S Sibio; L Siragusa; G S Sica Journal: Gastroenterol Res Pract Date: 2020-12-28 Impact factor: 2.260
Authors: Rosario Fornaro; Marco Frascio; Michela Caratto; Elisa Caratto; Rita Bianchi; Andrea Razzore; Giuseppe Caristo; Camilla Sticchi; Marco Casaccia Journal: Case Rep Gastroenterol Date: 2018-08-21