P Bayart1, N Duveau1, M Nachury1, P Zerbib2,3, R Gerard1, J Branche1, V Maunoury1, Pauline Wils1, A Boruchowicz4, M Boualit4, J-E Laberenne5, O Manolache5, P Desreumaux1,3, G Pineton de Chambrun6, B Pariente7,8. 1. Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille 2, Lille, France. 2. Digestive Surgery Department, Claude Huriez Hospital, University of Lille 2, Lille, France. 3. Inserm Unit 995, University of Lille 2, Lille, France. 4. Hepato-Gastroenterology Department, Valenciennes Hospital, Valenciennes, France. 5. Hepato-Gastroenterology Department, Seclin Hospital, Seclin, France. 6. Hepato-Gastroenterology Department, Saint-Eloi Hospital, CHRU, Montpellier, France. 7. Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille 2, Lille, France. benjamin.pariente@chru-lille.fr. 8. Inserm Unit 995, University of Lille 2, Lille, France. benjamin.pariente@chru-lille.fr.
Abstract
BACKGROUND: The Rutgeerts score with 5 grades of severity (i0-i4) is a suitable endoscopic model to predict clinical recurrence following ileocolonic resection in Crohn's disease (CD). Definition of grade i2 includes lesions confined to the ileocolonic anastomosis (i2a) or moderate lesions on the neo-terminal ileum (i2b). The aim of the present study was to evaluate the probability of clinical recurrence in i2a and i2b patients. METHODS: This multicenter retrospective study included all CD patients classified i2 at the first postoperative ileocolonoscopy. The primary outcome was to evaluate the probability of clinical recurrence in patients classified i2a and i2b. The secondary outcome was to compare the rate of global recurrence of CD. RESULTS: Fifty patients were included: 23 were classified i2a and 27 were classified i2b. The median duration of follow-up was 40 (18.0-80.4) months in the i2a group and 53.5 (25.0-69.0) months in the i2b group (p = 0.9). The probability of clinical recurrence was not significantly different between patients classified i2a and i2b (p = 0.64). Median time to clinical recurrence after the first ileocolonoscopy and probability of global CD recurrence were not different between the two groups (p ≥ 0.19). CONCLUSIONS: The rate of clinical postoperative recurrence is not different in i2a and i2b patients. These results suggest that the same therapeutic strategy should be used in all patients classified i2 on the Rutgeerts score whatever the location of postoperative CD recurrence.
BACKGROUND: The Rutgeerts score with 5 grades of severity (i0-i4) is a suitable endoscopic model to predict clinical recurrence following ileocolonic resection in Crohn's disease (CD). Definition of grade i2 includes lesions confined to the ileocolonic anastomosis (i2a) or moderate lesions on the neo-terminal ileum (i2b). The aim of the present study was to evaluate the probability of clinical recurrence in i2a and i2b patients. METHODS: This multicenter retrospective study included all CD patients classified i2 at the first postoperative ileocolonoscopy. The primary outcome was to evaluate the probability of clinical recurrence in patients classified i2a and i2b. The secondary outcome was to compare the rate of global recurrence of CD. RESULTS: Fifty patients were included: 23 were classified i2a and 27 were classified i2b. The median duration of follow-up was 40 (18.0-80.4) months in the i2a group and 53.5 (25.0-69.0) months in the i2b group (p = 0.9). The probability of clinical recurrence was not significantly different between patients classified i2a and i2b (p = 0.64). Median time to clinical recurrence after the first ileocolonoscopy and probability of global CD recurrence were not different between the two groups (p ≥ 0.19). CONCLUSIONS: The rate of clinical postoperative recurrence is not different in i2a and i2b patients. These results suggest that the same therapeutic strategy should be used in all patients classified i2 on the Rutgeerts score whatever the location of postoperative CD recurrence.
Authors: Alexandra D Frolkis; Jonathan Dykeman; María E Negrón; Jennifer Debruyn; Nathalie Jette; Kirsten M Fiest; Talia Frolkis; Herman W Barkema; Kevin P Rioux; Remo Panaccione; Subrata Ghosh; Samuel Wiebe; Gilaad G Kaplan Journal: Gastroenterology Date: 2013-07-27 Impact factor: 22.682
Authors: Alexandra D Frolkis; Debra S Lipton; Kirsten M Fiest; María E Negrón; Jonathan Dykeman; Jennifer deBruyn; Nathalie Jette; Talia Frolkis; Ali Rezaie; Cynthia H Seow; Remo Panaccione; Subrata Ghosh; Gilaad G Kaplan Journal: Am J Gastroenterol Date: 2014-10-21 Impact factor: 10.864
Authors: Peter De Cruz; Michael A Kamm; Amy L Hamilton; Kathryn J Ritchie; Efrosinia O Krejany; Alexandra Gorelik; Danny Liew; Lani Prideaux; Ian C Lawrance; Jane M Andrews; Peter A Bampton; Peter R Gibson; Miles Sparrow; Rupert W Leong; Timothy H Florin; Richard B Gearry; Graham Radford-Smith; Finlay A Macrae; Henry Debinski; Warwick Selby; Ian Kronborg; Michael J Johnston; Rodney Woods; P Ross Elliott; Sally J Bell; Steven J Brown; William R Connell; Paul V Desmond Journal: Lancet Date: 2014-12-24 Impact factor: 79.321
Authors: Laurent Peyrin-Biroulet; Edward V Loftus; Jean-Frederic Colombel; William J Sandborn Journal: Am J Gastroenterol Date: 2009-10-27 Impact factor: 10.864
Authors: Laurent Peyrin-Biroulet; W Scott Harmsen; William J Tremaine; Alan R Zinsmeister; William J Sandborn; Edward V Loftus Journal: Am J Gastroenterol Date: 2012-09-04 Impact factor: 10.864
Authors: Benjamin Pariente; Jacques Cosnes; Silvio Danese; William J Sandborn; Maïté Lewin; Joel G Fletcher; Yehuda Chowers; Geert D'Haens; Brian G Feagan; Toshifumi Hibi; Daniel W Hommes; E Jan Irvine; Michael A Kamm; Edward V Loftus; Edouard Louis; Pierre Michetti; Pia Munkholm; Tom Oresland; Julian Panés; Laurent Peyrin-Biroulet; Walter Reinisch; Bruce E Sands; Juergen Schoelmerich; Stefan Schreiber; Herbert Tilg; Simon Travis; Gert van Assche; Maurizio Vecchi; Jean-Yves Mary; Jean-Frédéric Colombel; Marc Lémann Journal: Inflamm Bowel Dis Date: 2010-11-28 Impact factor: 5.325
Authors: Gert Van Assche; Axel Dignass; Bernd Bokemeyer; Silvio Danese; Paolo Gionchetti; Gabriele Moser; Laurent Beaugerie; Fernando Gomollón; Winfried Häuser; Klaus Herrlinger; Bas Oldenburg; Julian Panes; Francisco Portela; Gerhard Rogler; Jürgen Stein; Herbert Tilg; Simon Travis; James O Lindsay Journal: J Crohns Colitis Date: 2012-10-03 Impact factor: 10.020
Authors: Jacob E Ollech; Maya Aharoni-Golan; Roni Weisshof; Inessa Normatov; Abby R Sapp; Aditya Kalakonda; Amanda Israel; Laura R Glick; Theodore Karrison; Sushila R Dalal; Atsushi Sakuraba; Russell D Cohen; David T Rubin; Joel Pekow Journal: Gastrointest Endosc Date: 2019-02-06 Impact factor: 9.427
Authors: Robert P Hirten; Ryan C Ungaro; Daniel Castaneda; Sarah Lopatin; Bruce E Sands; Jean Frederic Colombel; Benjamin L Cohen Journal: Inflamm Bowel Dis Date: 2020-06-18 Impact factor: 5.325
Authors: Anthony Buisson; Stéphane Nancey; Luc Manlay; David T Rubin; Xavier Hebuterne; Benjamin Pariente; Mathurin Fumery; David Laharie; Xavier Roblin; Gilles Bommelaer; Bruno Pereira; Laurent Peyrin-Biroulet; Lucine Vuitton Journal: United European Gastroenterol J Date: 2021-05-05 Impact factor: 4.623