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The Clinical Significance of Anastomotic Ulcers After Ileocolic Resection to Predict Postoperative Recurrence of Crohn's Disease
- Source :
- Digestive diseases and sciences. 66(9)
- Publication Year :
- 2020
-
Abstract
- The Rutgeerts score is used to predict postoperative recurrence in CD patients after ileocolic resection and is primarily based on endoscopic findings at the neoterminal ileum. However, the optimal assessment of anastomotic ulcers (AUs) remains subject to debate. We aimed to investigate the association between anastomotic ulcers (AUs) and endoscopic recurrence in postoperative Crohn’s disease (CD) patients. This single-center retrospective study, conducted between 2000 and 2016, evaluated postoperative CD patients with endoscopic remission at the first ileocolonoscopy within 1 year after ileocolic resection and those who underwent subsequent ileocolonoscopic follow-up. The study outcome was the clinical significance of AUs in predicting endoscopic recurrence. Among 116 patients who were in endoscopic remission defined as the RS of i0 to i1 at the index postoperative ileocolonoscopy, 84.5% (98/116) underwent subsequent ileocolonoscopies. During the median 30.0 months (interquartile range, 21.3–53.3) of follow-up after the first ileocolonoscopy, 56.1% (55/98) of patients showed endoscopic recurrence. Furthermore, 65.8% (48/73) with AUs and 75.5% (40/53) with major AUs, defined as either an ulcer occupying ≥ 1/4 of the circumference, ≥ 3 ulcers confined to anastomotic ring, or any ulcers extending to the ileocolonic mucosa, showed endoscopic recurrence. On multivariable analysis, AUs (adjusted hazard ratio [aHR], 4.33; 95% confidence interval [CI], 1.87–10.0; P
- Subjects :
- Adult
Male
medicine.medical_specialty
Physiology
Colon
Anastomosis
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Crohn Disease
Interquartile range
Ileum
Predictive Value of Tests
Recurrence
Internal medicine
Republic of Korea
medicine
Humans
Clinical significance
Endoscopy, Digestive System
Colectomy
Ulcer
Retrospective Studies
Crohn's disease
business.industry
Hazard ratio
Anastomosis, Surgical
Gastroenterology
Retrospective cohort study
Hepatology
medicine.disease
Prognosis
Confidence interval
Surgery
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Female
business
Subjects
Details
- ISSN :
- 15732568
- Volume :
- 66
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Digestive diseases and sciences
- Accession number :
- edsair.doi.dedup.....837ecc6ff7679df938c23467ed8fdb57