Surgical recurrence in Crohn’s disease: a comparison between different types of bowel resections

Aaltonen, Gisele; Carpelan-Holmström, Monika; Keränen, Ilona; Lepistö, Anna

doi:10.1007/s00384-018-2995-9

“…The present ndings revealed a difference between endoscopic recurrence in the anastomotic site and the causative lesion related to the reoperation. Among other studies presented thus far, Aaltonen G et al reported that the majority of cases of surgical recurrence (71.4%) were because of a lesion located in the proximal portion of the site of anastomosis and required a new ileocolic resection [3], while other studies also concluded that surgical recurrence after an ileocolic resection is more common in the anastomotic site [4,5]. Furthermore, the reoperation rate after stoma construction is high in CD patients.…”

Section: Discussionmentioning

confidence: 97%

Localization of recurrent lesions following ileocolic resection for Crohn's disease

Ikeuchi

¹

,

Uchino

²

,

Bando

³

et al. 2020

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Background Crohn’s disease (CD) recurrence can occur not only at the site of anastomosis but also elsewhere in the bowel following an ileocolic resection (ICR) procedure. The aims of the present study were to assess long-term outcomes of a primary ICR procedure for CD in consecutive patients and examine the location of the reoperation causative lesion.Methods We examined cases of surgery with ICR initially performed at our institution. Those with simultaneous multiple bowel resection or bowel resection with strictureplasty were excluded. Results A total of 169 patients who underwent ICR due to CD were enrolled. The median follow-up period was 12.6 years (range 4-27 years). A reoperation was needed in 45 (26.6%), of whom 14 had lesions causative of the reoperation at other than the anastomotic site. The most common causative lesion location was in the colon rather than the oral side of the small intestine. Furthermore, we investigated the relationship between presence of residual lesions following the initial surgery and lesions causative of reoperation. In the group without residual disease (n=31), 29.0% (n=9) had non-anastomotic lesions involved in indications for reoperation, while that was 35.7% (n=5) in the group with residual disease (n=14).Conclusions Anastomotic site lesion is not the only causative factor for reoperation following ICR. Regular examinations and applicable treatment with awareness that the cause of reoperation is not limited to the site of anastomosis are important in these cases.

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“…reported that the majority of cases of surgical recurrence (71.4%) were because of a lesion located in the proximal portion of the site of anastomosis and required a new ileocolic resection [3], while other studies also concluded that surgical recurrence after an ileocolic resection is more common in the anastomotic site [4,5]. Furthermore, the reoperation rate after stoma construction is high in CD patients.…”

Section: Discussionmentioning

confidence: 99%

Localization of recurrent lesions following ileocolic resection for Crohn's disease

Ikeuchi

¹

,

Uchino

²

,

Bando

³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Crohn’s disease (CD) recurrence can occur not only at the site of anastomosis but also elsewhere in the bowel following an ileocolic resection (ICR) procedure. The aims of the present study were to assess long-term outcomes of a primary ICR procedure for CD in consecutive patients and examine the location of the reoperation causative lesion.Methods We examined cases of surgery with ICR initially performed at our institution. Those with simultaneous multiple bowel resection or bowel resection with strictureplasty were excluded. Results A total of 169 patients who underwent ICR due to CD were enrolled. The median follow-up period was 12.6 years (range 4-27 years). A reoperation was needed in 45 (26.6%), of whom 14 had lesions causative of the reoperation at other than the anastomotic site. The most common causative lesion location was in the colon rather than the oral side of the small intestine. Furthermore, we investigated the relationship between presence of residual lesions following the initial surgery and lesions causative of reoperation. In the group without residual disease (n=31), 29.0% (n=9) had non-anastomotic lesions involved in indications for reoperation, while that was 35.7% (n=5) in the group with residual disease (n=14).Conclusions Anastomotic site lesion is not the only causative factor for reoperation following ICR. Regular examinations and applicable treatment with awareness that the cause of reoperation is not limited to the site of anastomosis are important in these cases.

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“…Aaltonen G et al reported that the majority of cases of surgical recurrence (71.4%) were because of a lesion located in the proximal portion of the anastomosis and required a new ileocolic resection [4], while other studies also concluded that surgical recurrence after an ileocolic resection is more common in the anastomosis [5,6]. Furthermore, the reoperation rate after stoma construction is high in CD patients.…”

Section: Discussionmentioning

confidence: 99%

Localization of recurrent lesions ileocolic resection for Crohn's disease

Ikeuchi

¹

,

Uchino

²

,

Bando

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background Crohn’s disease (CD) recurrence can occur not only at the site of anastomosis but also elsewhere in the bowel following ileocolic resection (ICR). The aims of the present study were to assess long-term outcomes of a primary ICR procedure for CD in consecutive patients and examine the location of the reoperation causative lesion. Methods We examined cases of surgery with ICR initially performed at our institution. Those with a simultaneous multiple bowel resection or bowel resection with strictureplasty were excluded. Results A total of 169 patients who underwent ICR due to CD were enrolled. The median follow-up period was 12.6 years (range 4–27 years). A reoperation was needed in 45 (26.6%), of whom 14 had lesions causative of the reoperation at other than the anastomotic site. The most common causative lesion location was in the colon rather than the oral side of the small intestine. Furthermore, we investigated the relationship between presence of residual lesions following the initial surgery and lesions causative of reoperation. In the group without residual disease (n = 31), 29.0% (n = 9) had non-anastomotic lesions involved in indications for reoperation, while that was 35.7% (n = 5) in the group with residual disease (n = 14). Conclusions Anastomotic site lesion is not the only causative factor for reoperation following ICR. Regular examinations and applicable treatment with awareness that the cause of reoperation is not limited to the site of anastomosis are important in these cases.

show abstract

Surgical recurrence in Crohn’s disease: a comparison between different types of bowel resections

Cited by 15 publications

References 18 publications

Localization of recurrent lesions following ileocolic resection for Crohn's disease

Localization of recurrent lesions following ileocolic resection for Crohn's disease

Localization of recurrent lesions following ileocolic resection for Crohn's disease

Localization of recurrent lesions ileocolic resection for Crohn's disease

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