Yusuf Erzin1, Gürhan Şişman1, İbrahim Hatemi1, Bilgi Baca2, İsmail Hamzaoglu2, Ahmet Dirican3, Uğur Korman4, Aykut F Çelik1. 1. Department of Gastroenterology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey. 2. Department of General Surgery, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey. 3. Department of Biostatistics, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey. 4. Department of Radiology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey.
Abstract
BACKGROUND/AIMS: This study aimed to determine the predictors of endoscopic recurrence in a cohort of patients with Crohn's disease (CD) with prior intestinal resections. MATERIALS AND METHODS: The charts of the patients with CD were reviewed in a retrospective manner. Eighty-three patients were eligible for the final analysis. Demographic features of these patients and time between resection and colonoscopy, presence of any macroscopic residual disease in the remnant intestine, and postoperative medications were noted. Rutgeerts score was used to define postoperative endoscopic recurrence. RESULTS: The patients' mean age±SD at their final colonoscopy was 42.81±11.99 yr; and 37 of 83 patients (45%) were female. The mean follow-up time between resection and the final colonoscopy was 51.16±51.08 months. A total of 51 of 83 patients (61%) were in endoscopic remission (i0, i1); whereas 32 (39%) had an endoscopic recurrence (i2, i3, i4). History of multiple resections (χ2=6.12; p=0.013) and the presence of any postoperative residual disease in the remnant intestine (χ2=5.86; p=0.015) were risk factors; whereas the regular use of azathioprine (AZA) was significantly more common among patients without recurrence (χ2=4.515; p=0.034). In an age-sex adjusted Cox regression analysis history of multiple resections, presence of any postoperative residual disease proved to be independent risk factor for endoscopic recurrence, whereas the regular use of AZA proved to be ineffective. CONCLUSION: In a retrospective long-term follow-up cohort of resected patients with CD, having multiple resections for CD and the presence of any residual synchronous disease after ileocolonic resection were identified as risk factors for endoscopic recurrence; the latter was never reported in previous studies.
BACKGROUND/AIMS: This study aimed to determine the predictors of endoscopic recurrence in a cohort of patients with Crohn's disease (CD) with prior intestinal resections. MATERIALS AND METHODS: The charts of the patients with CD were reviewed in a retrospective manner. Eighty-three patients were eligible for the final analysis. Demographic features of these patients and time between resection and colonoscopy, presence of any macroscopic residual disease in the remnant intestine, and postoperative medications were noted. Rutgeerts score was used to define postoperative endoscopic recurrence. RESULTS: The patients' mean age±SD at their final colonoscopy was 42.81±11.99 yr; and 37 of 83 patients (45%) were female. The mean follow-up time between resection and the final colonoscopy was 51.16±51.08 months. A total of 51 of 83 patients (61%) were in endoscopic remission (i0, i1); whereas 32 (39%) had an endoscopic recurrence (i2, i3, i4). History of multiple resections (χ2=6.12; p=0.013) and the presence of any postoperative residual disease in the remnant intestine (χ2=5.86; p=0.015) were risk factors; whereas the regular use of azathioprine (AZA) was significantly more common among patients without recurrence (χ2=4.515; p=0.034). In an age-sex adjusted Cox regression analysis history of multiple resections, presence of any postoperative residual disease proved to be independent risk factor for endoscopic recurrence, whereas the regular use of AZA proved to be ineffective. CONCLUSION: In a retrospective long-term follow-up cohort of resected patients with CD, having multiple resections for CD and the presence of any residual synchronous disease after ileocolonic resection were identified as risk factors for endoscopic recurrence; the latter was never reported in previous studies.
Authors: Laurent Peyrin-Biroulet; Pierre Deltenre; Sandro Ardizzone; Geert D'Haens; Stephen B Hanauer; Hans Herfarth; Marc Lémann; Jean-Frédéric Colombel Journal: Am J Gastroenterol Date: 2009-06-30 Impact factor: 10.864
Authors: Bruce E Sands; Joanne E Arsenault; Michael J Rosen; Mazen Alsahli; Laurence Bailen; Peter Banks; Steven Bensen; Athos Bousvaros; David Cave; Jeffrey S Cooley; Herbert L Cooper; Susan T Edwards; Richard J Farrell; Michael J Griffin; David W Hay; Alex John; Sheldon Lidofsky; Lori B Olans; Mark A Peppercorn; Richard I Rothstein; Michael A Roy; Michael J Saletta; Samir A Shah; Andrew S Warner; Jacqueline L Wolf; James Vecchio; Harland S Winter; John K Zawacki Journal: Am J Gastroenterol Date: 2003-12 Impact factor: 10.864
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: David B Sachar; Eric Lemmer; Christopher Ibrahim; Yair Edden; Thomas Ullman; Julie Ciardulo; Esther Roth; Adrian J Greenstein; Joel J Bauer Journal: Inflamm Bowel Dis Date: 2009-07 Impact factor: 5.325