Post-operative recurrence of Crohn's disease: A prospective study at 5 years

Tailored Medical Management of the Complex Postoperative Crohn's Disease Patient

“…15,16 The Role of Endoscopy in Guiding Postoperative Crohn's Disease Management Endoscopic recurrence typically precedes clinical symptoms following surgery for Crohn's disease with evidence of endoscopic disease in the neoterminal ileum in as many as 70 to 90% of patients 1 year following ileocolonic resection and anastomosis. [17][18][19] Given this rapid and high rate of recurrence, endoscopic evaluation for Crohn's disease in the postoperative setting has been shown to be helpful for both diagnostic and risk stratification purposes. In a study evaluating the pattern of endoscopic recurrence in 114 patients who had serial colonoscopies after undergoing ileocolonic resection, 77% of patients developed endoscopic recurrence within 1 year of surgery with disease typically confined to the neoterminal ileum and anastomosis.…”

Risk of Late Postoperative Recurrence of Crohn’s Disease in Patients in Endoscopic Remission After Ileocecal Resection, Over 10 Years at Multiple Centers

“…7 In general, such patients do not require new therapy, nor intensification of existing therapy. 8 Since most studies in postoperative CD patients aimed to assess the evolution of patients with Rutgeerts score of i2 or higher, 9,10 little is known about the long-term outcome of patients without endoscopic CD recurrence after ileocecal resection. Although the original paper of Rutgeerts et al 4 looked at clinical recurrence during follow-up in this subgroup, data about hospitalization, intra-abdominal bowel damage, and the need for endoscopic balloon dilatation or redo-surgery were lacking.…”

Evolving roles of cross-sectional imaging in Crohn's disease

“…Some studies report that the risk of endoscopic recurrence in CD may be as high as 62% and 75% six and twelve months after resection respectively [77], while clinical and surgical recurrences occur in up to 80% and 50% of cases, respectively, after a 20-year followup [78]. Noteworthy, the severity of endoscopic recurrence at the anastomosis site six and twelve months after surgery, as assessed by Rutgeerts' score [76], has been found to significantly predict the risk of clinical recurrence [79,80], and ileocolonoscopy findings are currently used to guide the therapeutic management of CD in the post-surgical setting. In this clinical context, promising results have been reported for the cross-sectional imaging techniques, which may therefore represent valuable alternatives to frequent colonoscopies.…”