AIM: Ileocolonic resection is reserved for patients with moderate to severe Crohn's disease. Postoperative clinical recurrence can occur in up to 55% of patients within 5 years. Predicting the risk of recurrence is key in deciding upon appropriate treatment strategies. This study aims to determine the incidence of postoperative clinical recurrence and predictors of recurrence in a specialist institution. METHOD: The clinical case records of 142 patients who underwent either a one-stage or two-stage procedure for ileocolonic Crohn's disease from 1 January 2005 to 31 December 2010 were reviewed. Preoperative, perioperative and postoperative variables were extracted. Postoperative clinical recurrence was defined as an initiation or change in medical treatment for recurrent symptoms with endoscopic or radiological evidence of active disease. Time to clinical recurrence was measured in months after surgery. Univariate and multivariate analyses were performed. RESULTS: Over the 6-year period, follow-up data were obtained on 142 patients over a median of 28.5 months. Clinical recurrence was demonstrated in 59 (41.5%) patients. The proportion of patients with clinical recurrence at 5 years was 48.2%. Predictors of recurrence included a re-resection for recurrent disease [hazard ratio (HR) 1.9; 95% CI 1.1-3.3; P = 0.02] and ileocolonic disease (HR 1.7; 95% CI 1.0-2.9; P = 0.05). CONCLUSION: Identifying the predictors for postoperative clinical recurrence is important for determining the postoperative strategy. This study provides a unique perspective on the incidence of recurrence and associated predictors from the perspective of a specialist unit. Colorectal Disease
AIM: Ileocolonic resection is reserved for patients with moderate to severe Crohn's disease. Postoperative clinical recurrence can occur in up to 55% of patients within 5 years. Predicting the risk of recurrence is key in deciding upon appropriate treatment strategies. This study aims to determine the incidence of postoperative clinical recurrence and predictors of recurrence in a specialist institution. METHOD: The clinical case records of 142 patients who underwent either a one-stage or two-stage procedure for ileocolonic Crohn's disease from 1 January 2005 to 31 December 2010 were reviewed. Preoperative, perioperative and postoperative variables were extracted. Postoperative clinical recurrence was defined as an initiation or change in medical treatment for recurrent symptoms with endoscopic or radiological evidence of active disease. Time to clinical recurrence was measured in months after surgery. Univariate and multivariate analyses were performed. RESULTS: Over the 6-year period, follow-up data were obtained on 142 patients over a median of 28.5 months. Clinical recurrence was demonstrated in 59 (41.5%) patients. The proportion of patients with clinical recurrence at 5 years was 48.2%. Predictors of recurrence included a re-resection for recurrent disease [hazard ratio (HR) 1.9; 95% CI 1.1-3.3; P = 0.02] and ileocolonic disease (HR 1.7; 95% CI 1.0-2.9; P = 0.05). CONCLUSION: Identifying the predictors for postoperative clinical recurrence is important for determining the postoperative strategy. This study provides a unique perspective on the incidence of recurrence and associated predictors from the perspective of a specialist unit. Colorectal Disease
Authors: Pritesh S Morar; James Hollingshead; Willem Bemelman; Nick Sevdalis; Thomas Pinkney; Graeme Wilson; Malcolm Dunlop; R Justin Davies; Richard Guy; Nicola Fearnhead; Steven Brown; Janindra Warusavitarne; Cathryn Edwards; Omar Faiz Journal: J Crohns Colitis Date: 2017-10-27 Impact factor: 9.071
Authors: Sung Bae Kim; Jae Hee Cheon; Jae Jun Park; Eun Soo Kim; Seong Woo Jeon; Sung-Ae Jung; Dong Il Park; Chang Kyun Lee; Jong Pil Im; You Sun Kim; Hyun Soo Kim; Jun Lee; Chang Soo Eun; Jeong Mi Lee; Byung Ik Jang; Geom Seog Seo Journal: Gut Liver Date: 2020-05-15 Impact factor: 4.519