What are the predictors for recurrence of Crohn's disease after surgery?

Özgür, İlker; Kulle, Cemil Burak; Büyük, Melek; Örmeci, Aslı; Akyüz, Filiz; Balık, Emre; Bulut, Türker; Keskin, Metin

doi:10.1097/md.0000000000025340

Cited by 10 publications

(2 citation statements)

References 52 publications

(10 reference statements)

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“…Regarding the penetrating disease, Ozgur et al retrospectively reported an association between penetrating behavior (p = 0.011), intra-abdominal abscess (p = 0.040) and postoperative disease recurrence [43]. A subsequent meta-analysis of six RCTs reproduced these results.…”

Section: Disease Characteristicsmentioning

confidence: 91%

Management of Post-Operative Crohn’s Disease: Knowns and Unknowns

Spertino,

Gabbiadini,

Dal Buono

et al. 2024

JCM

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Crohn’s disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract characterized by relapsing–remission phases. CD often requires surgical intervention during its course, mainly ileo-cecal/ileo-colonic resection. However, surgery in CD is not curative and post-operative recurrence (POR) can happen. The management of CD after surgery presents challenges. Ensuring timely, effective, and safe therapy to prevent POR is essential but difficult, considering that approximately 20–30% of subjects may not experience endoscopic POR and that 40–50% will only exhibit intermediate lesions, which carry a low risk of mid- and long-term clinical and surgical POR. Currently, there are two accepted intervention strategies: early post-operative prophylactic therapy (systematically or based on the patient’s risk of recurrence) or starting therapy after confirming endoscopic POR 6–12 months after surgery (endoscopy-driven prophylactic therapy). The risk of overtreatment lies in exposing patients to undesired adverse events, along with the costs associated with medications. Conversely, undertreatment may lead to missed opportunities to prevent bowel damage and the necessity for additional surgery. This article aims to perform a comprehensive review regarding the optimal strategy to reduce the risk of POR in CD patients and the current therapeutic options.

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Section: Disease Characteristicsmentioning

confidence: 91%

Management of Post-Operative Crohn’s Disease: Knowns and Unknowns

Spertino,

Gabbiadini,

Dal Buono

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…High post‐operative recurrence rates have encouraged multiple studies to attempt to identify specific patterns of disease which predict recurrence 7 . Identified risk factors for post‐operative disease recurrence include disease location, surgical indication, 8,9 age, disease phenotype, 10 colonic and perianal involvement, 11,12 urgent operation and post‐operative steroid use 13 …”

Section: Introductionmentioning

confidence: 99%

Long‐term outcomes following ileocolic resection for Crohn's disease: does earlier elective resection affect disease recurrence rates?

Assaf,

Hazzan,

Laks

et al. 2023

ANZ Journal of Surgery

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BackgroundSurgical resection in Crohn's disease is sometimes the only alternative treating disease complications or refractory disease. The implications of early resection on disease course are still debatable. We aimed to assess the influence of preoperative disease duration on long‐term postoperative disease course.MethodsA retrospective analysis of all Crohn's disease patients who underwent an elective primary ileocolic resection between 2010 and 2021 in a single tertiary medical center. The cohort was divided based on disease duration, Group A (47 patients) had a disease duration shorter than 3 years (median of 1 year) and Group B (139 patients) had a disease duration longer than 3 years (median of 11 years).ResultsSurgeries were less complex among Group A as noted by higher rates of laparoscopic assisted procedures (68.1% vs. 45.3%, P = 0.006), shorter surgery duration (134 vs. 167 min, P < 0.0001) less estimated blood loss (72.5 vs. 333 mL, P = 0.016) and faster return of bowel function (3 vs. 4 days, P = 0.011). However, propensity score matching nullified all the differences. Younger age (OR = 0.86, P = 0.004), pre‐op steroids (OR = 3.69, P = 0.037) and longer disease duration (OR = 1.18, P = 0.012) were found to be independently significantly associated with severe complications. After a median follow‐up time of 71.38 months no significant differences were found between the groups in terms of endoscopic (P = 0.59), or surgical recurrences rates (P = 0.82).ConclusionsThe main effect of preoperative short disease duration was noted within the surgical complexity; however, matching suggests confounders as cause of the difference. No significant long‐term implication was noted on disease recurrence.

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The disease recurrence perception scale for patients with inflammatory bowel disease: Instrument development and cross‐sectional validation study

Xu,

Li,

Liu

et al. 2024

Research in Nursing & Health

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Disease recurrence perception plays a key role in disease management and subsequent disease recurrence prevention. However, there are no specific tools for assessing disease recurrence perception in patients with inflammatory bowel disease (IBD) characterized by alternating remission and recurrence. To develop and validate an instrument for measuring disease recurrence perception of patients with IBD, the study was conducted in two steps: (1) instrument development and (2) psychometric tests. A total of 623 patients with IBD participated in the study. The common sense model of illness self‐regulation (CSM) was used as a framework for instrument development. The administered version contained 48 items intended to be relevant to at least one of the six dimensions of the model. Based on preliminary analyzes, 12 items were deleted leaving 36 items for more detailed psychometric and factor analyzes. The Cronbach's alpha coefficient of the total 36‐item instrument was 0.915. The content validity indexes at item and scale levels were satisfactory. The test‐retest reliability of the total instrument was 0.870. Exploratory principal components analysis (n = 278) was used to identify six components congruent with intended CSM constructs that accounted for 62.6% of total item variance. Confirmatory factor analysis (n = 345) found acceptable fit for the six factor measurement model (χ2/df = 1.999, GFI = 0.846, NFI = 0.855, IFI = 0.922, TLI = 0.910, CFI = 0.921, RMSEA = 0.054). Overall, the DRPSIBD demonstrated satisfactory reliability and validity to warrant further development as a measure of disease recurrence perception of patients with IBD.

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What are the predictors for recurrence of Crohn's disease after surgery?

Cited by 10 publications

References 52 publications

Management of Post-Operative Crohn’s Disease: Knowns and Unknowns

Management of Post-Operative Crohn’s Disease: Knowns and Unknowns

Long‐term outcomes following ileocolic resection for Crohn's disease: does earlier elective resection affect disease recurrence rates?

The disease recurrence perception scale for patients with inflammatory bowel disease: Instrument development and cross‐sectional validation study

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