Previous colonic resection is a risk factor for surgical relapse in Crohn’s disease

Coletta, Marina; Zefelippo, Arianna; Mazza, Stefano; D'Abrosca, Vera; Botti, F.; Oreggia, Barbara; Prati, M.; Boni, Luigi; Vecchi, Maurizio; Caprioli, Flavio

doi:10.1016/j.dld.2018.07.035

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…Forth, the role of disease location on postoperative CD remains controversial, and conflicting data have been reported in literature. [7][8][9]21,22 In our study, a majority of patients (80%) had all preoperative lesions resected; however, it is possible that postoperative colonic inflammation was due to pre-existing minor lesions, which was not resected with surgery in a small proportion of patients with colon-dominant disease. Given that postoperative colonic involvement significantly increased the risk of clinical recurrence, we suggest that it would need an appropriate monitoring and SES-CD can be a candidate for this purpose.…”

Section: Discussionmentioning

confidence: 78%

Predictability of simple endoscopic score for Crohn's disease for postoperative outcomes in Crohn's disease

Akiyama

Yamada

Ollech

et al. 2021

J of Gastro and Hepatol

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Background and Aim:Approximately half of patients with Crohn's disease (CD) who have surgery will experience clinical recurrence within 10 years of their surgery. This study aimed to assess the postoperative outcomes according to disease location and validated the simple endoscopic score for CD (SES-CD) to predict disease-related outcomes. Methods: We retrospectively assessed medical records of CD patients who underwent ileocolonoscopy within 12 months after surgery at the University of Chicago between 2005 and 2016. We defined patients with postoperative colonic inflammation at the first postoperative ileocolonoscopy or had Montreal classification L2 as colon-dominant disease and patients without colonic involvement or who had L1 as small intestine (SI)-dominant disease. The outcomes included clinical and surgical recurrence. Results: Among 207 CD patients, 51 (24.6%) and 156 (75.4%) patients had colon-dominant and SI-dominant disease, respectively. Patients with colon-dominant disease had a greater risk of postoperative clinical recurrence compared with those with SI-dominant disease (P = 0.018). Colon-dominant disease was a risk of earlier surgical recurrence compared with SI-dominant disease, although there were no significant differences in the recurrence-free survivals. SES-CD > 2 at the first postoperative ileocolonoscopy was a significant risk of clinical recurrence on log-rank test (P < 0.001) and Cox proportional hazards model (hazard ratio = 2.25; 95% confidence interval = 1.14-4.47; P = 0.020). An SES-CD of 1 was an appropriate cut-off to predict the clinical recurrence of SI-dominant disease, but a higher SES-CD cut-off value of 5 was required for colon-dominant disease. Conclusions: We demonstrated that SES-CD predicts postoperative clinical recurrence of CD, regardless of disease location.

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Section: Discussionmentioning

confidence: 78%

Predictability of simple endoscopic score for Crohn's disease for postoperative outcomes in Crohn's disease

Akiyama

Yamada

Ollech

et al. 2021

J of Gastro and Hepatol

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“…15 studies [ 13 , 15 , 17 – 20 , 22 , 23 , 25 – 27 , 31 – 34 ] mentioned smoking. Due to low heterogeneity (I 2 = 0, P = 0.902), a fixed-effects model was applied, and the result suggested that smoking was a risk factor for ePOR [OR = 2.06, 95% CI (1.65, 2.57), P = 0.0001] (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Of the included 23 studies published from 2015 to 2023, 5 were case-control studies [13][14][15][16][17] and 18 were cohort studies [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. Among them, 3 were from the Netherlands [19,20,33], 3 each from Italy [13,23,24] and China [15,28,31], 4 each from France [18,25,30,32] and the United States [21,26,27,29], and 1 each from Korea [14], Belgium [22], Portugal [16], Japan [34], Israel [35], and Brazil [17].…”

Section: Basic Featuresmentioning

confidence: 99%

Section: Basic Featuresmentioning

confidence: 99%

“…The results demonstrated that the ePOR rate was [ES = 0.55, 95% CI (0.47, 0.63)] in Europe, [ES = 0.24, 95% CI (0.13, 0.35)] in North America, [ES = 0.53, 95% CI (0.32, 0.73)] in Asia, and [ES = 0.34, 95% CI (0.26, 0.42)] in South America. As for study types, 17 were observational cohort studies [18][19][20][21][22][23][24][25][26][27][28][29][30][32][33][34][35] and 5 were case-control studies [13][14][15][16][17]. The results showed that the ePOR rate of observational cohort studies was [ES = 0.48, 95%CI (0.38, 0.59)] and the ePOR rate of case-control studies was [ES = 0.48, 95%CI (0.39, 0.57)].…”

Section: Meta-analysis Of Subgroup Analysismentioning

confidence: 99%

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Risk factors for endoscopic postoperative recurrence in patients with Crohn’s Disease: a protocol for systematic review and meta-analysis

Ma,

Li,

et al. 2024

BMC Gastroenterol

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Background Crohn’s disease (CD) is a chronic condition characterized by a high recurrence rate after surgery, which seriously affects the quality of life of patients. Many studies have explored the risk factors for the recurrence of CD after surgery, there is a lack of meta-analysis focusing on endoscopic postoperative recurrence (ePOR) as a clinical outcome. Therefore, this paper aims to identify the risk factors for ePOR in CD patients through systematic review and meta-analysis. Methods PubMed, Embase, Cochrane Library, and Web of Science databases were searched for related literature from inception to 17th October 2023. Two researchers independently screened the literature and extracted information. Data analysis was performed using Stata18.0. Results Twenty-three papers were included, with 5 case-control studies and 18 cohort studies. The National Institutes of Health quality assessment tool rated 17 studies as good and 6 studies as fair. The sample size of the 23 studies ranged from 40 to 346, and the number of patients with ePOR ranged from 23 to 169. The results of multivariate meta-analysis showed that smoking [OR = 2.06, 95% CI (1.65, 2.57), P = 0.0001], previous ileocolonic resection [OR = 1.71, 95% CI (1.23, 2.38), P = 0.002], disease localization at ileocolic resection [OR = 2.68, 95% CI (1.38, 5.22), P = 0.004], perianal disease [OR = 1.47, 95% CI (1.07, 2.03), P = 0.017], and anastomotic scattered ulcer [OR = 3.39, 95% CI (1.83, 6.28), P = 0.001] were risk factors for ePOR in CD patients. Postoperative prophylactic medication [OR = 0.53, 95% CI (0.38,0.75), P = 0.0001] was a protective factor for ePOR in CD patients. Conclusions This systematic review identified multiple factors for ePOR in CD patients, as well as a protective factor. However, the number of articles included was limited. More high-quality clinical studies are required to further validate the conclusions. Trial registration This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023483671).

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Postoperative platelet count is a prognostic biomarker of surgical recurrence in Crohn's disease

Tsunoda,

Shigeta,

Mizuno

et al. 2024

Journal of Gastrointestinal Surgery

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Previous colonic resection is a risk factor for surgical relapse in Crohn’s disease

Cited by 5 publications

References 26 publications

Predictability of simple endoscopic score for Crohn's disease for postoperative outcomes in Crohn's disease

Predictability of simple endoscopic score for Crohn's disease for postoperative outcomes in Crohn's disease

Risk factors for endoscopic postoperative recurrence in patients with Crohn’s Disease: a protocol for systematic review and meta-analysis

Postoperative platelet count is a prognostic biomarker of surgical recurrence in Crohn's disease

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