<scp>SupportiNg operAtive</scp> Photographic documentation in ileocolonic <scp>CROHN</scp>'s disease surgery: The <scp>SNAPCROHN</scp> study

Celentano, Valerio; Adamina, Michel; Spinelli, Antonino; Fleshner, Phillip; Pellino, Gianluca; Mineccia, Michela; Selvaggi, Francesco; Svrcek, Magali; Tozer, P; Espín‐Basany, Eloy; Hancock, Laura; Faiz, O; Coffey, Calvin; Sampietro, Gianluca

doi:10.1111/codi.16342

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…A clinical operative synoptic report can overcome this deficiency and ensure that all relevant and pertinent information is reported. This was echoed by SNAPCROHN study that recommended intraoperative photographic documentation of CD surgery 7 . Similar synoptic reports have been developed and used in the clinical settings such as operative reports for cancers, 8 histopathology for cancers and imaging for rectal cancers 9 .…”

Section: Introductionmentioning

confidence: 94%

“…This was echoed by SNAPCROHN study that recommended intraoperative photographic documentation of CD surgery. 7 Similar synoptic reports have been developed and used in the clinical settings such as operative reports for cancers, 8 histopathology for cancers and imaging for rectal cancers. 9 They have been shown to improve the quality of the operative reports.…”

Section: Introductionmentioning

confidence: 99%

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Proposed clinical operative synoptic report for ileocolic resection for Crohn's disease

Ng,

Mackenzie,

Gilmore

et al. 2024

ANZ Journal of Surgery

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BackgroundCrohn's disease patients may require multiple surgeries during their lifetime. Because operative reports are not standardized, information relevant to future management may not be documented. Synoptic reports used in other fields such as histopathology have proven to be effective and allow consistent documentation of results. The aim of this study was to retrospectively review the completeness of the operative reports for ileocolic Crohn's resections (ICR) and to propose a synoptic report.MethodsA draft synoptic operative report for ICR for Crohn's disease was presented in the IBD multidisciplinary meeting and a Delphi process used to gain consensus for inclusion in the synoptic report. Retrospective analysis of consecutive ICR from January 2010 to April 2023 was undertaken to determine the presence of the standardized criteria.ResultsA total of 66 ICR were performed in 63 patients during the study period. No operation reports were excluded. The examination of bowel for macroscopic disease was partially documented in 88% cases. The extent of mesenteric resection and any difficulty encountered during dissection were poorly documented. The remaining length of small and large intestines was not documented in most operative reports. The clinical sections that were compulsory entrance in the electronic operative report achieved 100% compliance.ConclusionThis study has demonstrated that key information was often deficient in the operative report. This may have a significant impact on the future management of Crohn's patients and affects the interpretation of research outcomes. A proposed clinical synoptic operative report is easy to use and ensures compliance.

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Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Proposed clinical operative synoptic report for ileocolic resection for Crohn's disease

Ng,

Mackenzie,

Gilmore

et al. 2024

ANZ Journal of Surgery

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“…Accurate quantitation and documentation of mesenteric disease manifestations would in turn enhance capacity to systematically study the mesentery in Crohn's disease. 61…”

Section: Future Directionsmentioning

confidence: 99%

The Surgical Management of the Mesentery in Crohn's Disease

Coffey,

Devine

2024

Clin Colon Rectal Surg

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Increasing evidence suggests that Crohn's disease is a primary mesenteropathy and that resection of the mesentery, or its exclusion from an anastomosis, may alter disease progression. If borne out in clinical trials, this observation would be welcome, as current pharmacotherapeutic approaches to Crohn's disease appear to have limited effect on disease progression. This article explores arguments for and against the alteration of mesenteric inputs by surgical means, in Crohn's disease.

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Appearance of the Bowel and Mesentery During Surgery Is Not Predictive of Postoperative Recurrence After Ileocecal Resection for Crohn’s Disease: A Prospective Monocentric Study

Bislenghi,

Van Den Bossch,

Fieuws

et al. 2023

Inflammatory Bowel Diseases

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Background Very few risk factors for postoperative recurrence (POR) of Crohn’s Disease (CD) after ileocecal resection have been identified. The aim of the present study was to verify the association between an a priori defined list of intraoperative macroscopic findings and POR. Methods This was a prospective observational study including patients undergoing primary ileocecal resection for CD. Four intraoperative factors were independently evaluated by 2 surgeons: length of resected ileum, mesentery thickness, presence of areas of serosal fat infiltration, or abnormal serosal vasodilation on normal bowel proximal to the resected bowel. The primary end point was early endoscopic POR at month 6 and defined as modified Rutgeerts score ≥i2b. Secondary end points were clinical and surgical recurrence. Results Between September 2020 and November 2022, 83 consecutive patients were included. Early endoscopic recurrence occurred in 45 of 76 patients (59.2%). Clinical and biochemical recurrence occurred in 17.3% (95% confidence interval, [CI], 10.4%-28.0%) and 14.6% of the patients after 12 months. The risk of developing endoscopic and clinical recurrence was 1.127 (95% CI, 0.448;2.834, P = .799) and 0.896 (95% CI, 0.324-2.478, P = .832) when serosal fat infiltration was observed, and 1.388 (95% CI, 0.554-3.476, P = .484), and 1.153 (95% CI, 0.417;3.187, P = .783) when abnormal serosal vasodilation was observed. Similarly, length of the resected bowel and mesentery thickness showed no association with POR. A subgroup analysis on patients who received no postoperative medical prophylaxis did not identify any risk factor for endoscopic POR. Conclusions The macroscopic appearance of the bowel and associated mesentery during surgery does not seem to be predictive of POR after ileocecal resection for CD.

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SupportiNg operAtive Photographic documentation in ileocolonic CROHN's disease surgery: The SNAPCROHN study

Cited by 4 publications

References 19 publications

Proposed clinical operative synoptic report for ileocolic resection for Crohn's disease

Proposed clinical operative synoptic report for ileocolic resection for Crohn's disease

The Surgical Management of the Mesentery in Crohn's Disease

Appearance of the Bowel and Mesentery During Surgery Is Not Predictive of Postoperative Recurrence After Ileocecal Resection for Crohn’s Disease: A Prospective Monocentric Study

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