Anorectal stricture in 102 patients with Crohn's disease: natural history in the era of biologics

Brochard, Charlène; Siproudhis, L.; Wallenhorst, Timothée; Cuen, David; D’Halluin, Pierre-Nicolas; Garros, Aurélien; Bretagne, Jean–François; Bouguen, Guillaume

doi:10.1111/apt.12894

Cited by 42 publications

(29 citation statements)

References 19 publications

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“…At this time, optimal frequency and modalities of surveillance are unknown. 3,16 In addition, the frequent presence of anorectal impassable strictures, 17 and initial location of malignant lesions in inaccessible fistula tracts make the surveillance difficult, if not, in some cases, impossible. 18,19 Dedicated consensus and guidelines regarding the detection of advanced anorectal neoplasia in patients with anal and/or perianal Crohn's disease are now eagerly awaited.…”

Section: Discussionmentioning

confidence: 99%

High Risk of Anal and Rectal Cancer in Patients With Anal and/or Perianal Crohn’s Disease

Carrat

Zeitoun

Fléjou

et al. 2018

Clinical Gastroenterology and Hepatology

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Section: Discussionmentioning

confidence: 99%

High Risk of Anal and Rectal Cancer in Patients With Anal and/or Perianal Crohn’s Disease

Carrat

Zeitoun

Fléjou

et al. 2018

Clinical Gastroenterology and Hepatology

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“…tub1 = Well-differentiated tubular adenocarcinoma; muc = mucinous adenocarcinoma; scc = squamous cell carcinoma. Japan, anorectal cancer is common; therefore, in addition to the colonoscopy, the biopsy of the perianal region is necessary for adequate surveillance [26][27][28][29][30] . We performed surveillance in patients with complicated perianal lesions that had persisted for at least 7 years.…”

Section: Discussionmentioning

confidence: 99%

Detection of Anorectal Cancer among Patients with Crohn's Disease Undergoing Surveillance with Various Biopsy Methods

et al. 2016

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Background/Aims: Crohn's disease (CD) is an inflammatory bowel disease. The risk of colorectal cancer (CRC) is increased in patients with CD. In Japan, anorectal cancer accounted for >60% of CRCs associated with CD. These anorectal cancers are typically diagnosed in advanced stages, because a surveillance protocol remains to be established. This study aimed to assess various biopsy methods for detecting CRC. Methods: This study included 72 patients (113 examinations) with CD who underwent cancer surveillance between August 2008 and October 2015. Surveillances were performed with a core needle biopsy in perianal regions (54 cases), endoscopic biopsy (90 cases), and excisional biopsy (34 cases). When it was difficult to perform colonoscopy in an outpatient setting, due to perianal pain or stricture, we employed examinations under anesthesia for surveillance. Results: The total CRC detection rate was 6.19% (7 examinations). CRC detection rates were 1.85% (1 case) with core needle biopsy, 5.56% (5 cases) with endoscopic biopsy, and 5.88% (2 cases) with excisional biopsy. Conclusions: We showed that it was important to employ various biopsy methods in cancer surveillance to detect CRC among patients with CD.

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“…Anal stricture does not remain a healing scare with non-reversible consequence since it is associated to inflammatory processes such as ulceration and fistulas. In fact, biologics may improve and reverse this condition [25].…”

Section: Discussionmentioning

confidence: 99%

Crohn’s disease: is there any link between anal and luminal phenotypes?

Wallenhorst

Brochard

Bretagne

et al. 2015

Int J Colorectal Dis

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PurposePerianal Crohn's disease (CD) encompasses a variety of lesion similar to luminal disease, which are usually not distinctly assessed. Links between luminal and perianal CD phenotype remains therefore underreported, and we aimed to describe both luminal and perianal phenotype and their relationships. MethodsFrom January 2007, clinical data of all consecutive patients with CD seen in a referral center were prospectively recorded. Data recorded until October 2011 were extracted and reviewed for study proposal. ResultsA total of 282 patients (M/F, 108/174; aged 37.8 ± 16.2 years) were assessed that included 154 cases (54.6 %) with anal ulceration, 118 cases (41.8 %) with fistula, 49 cases (17.4 %) with stricture, and 94 cases without anal lesion (33.3 %). Anal ulcerations were associated with fistulas (N = 87/154) in more than half of patients (56.5 %) and were isolated in 55 patients (35.7 %). Most of strictures (94 %) were associated with other lesions (N = 46/49). Harvey-Bradshaw score was significantly higher in patients with ulcerations (p < 0.001) as compared to those with perianal fistulas (p = 0.15) or with anal strictures (p = 0.16). Proportions of complicated behavior (fistulizing or stricturing) of luminal CD were similar according to anal lesions: anal fistulas were not significantly associated to penetrating Montreal phenotype (N = 4/31 p = 0.13) as well as anal stricture and stricturing Montreal phenotype (N = 3/49, p = 0.53).

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Anorectal stricture in 102 patients with Crohn's disease: natural history in the era of biologics

Abstract: SUMMARY BackgroundThe natural history of nonfistulising perianal Crohn's disease (PCD) remains unknown.

Cited by 42 publications

References 19 publications

High Risk of Anal and Rectal Cancer in Patients With Anal and/or Perianal Crohn’s Disease

High Risk of Anal and Rectal Cancer in Patients With Anal and/or Perianal Crohn’s Disease

Detection of Anorectal Cancer among Patients with Crohn's Disease Undergoing Surveillance with Various Biopsy Methods

Crohn’s disease: is there any link between anal and luminal phenotypes?

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