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The Clinical Significance of Anastomotic Ulcers After Ileocolic Resection to Predict Postoperative Recurrence of Crohn's Disease

Authors :
Jeongseok Kim
Chang Sik Yu
Jin Yong Kim
Sang Hyoung Park
Sung Wook Hwang
Soomin Noh
Jeong-Sik Byeon
Suk-Kyun Yang
Dong-Hoon Yang
Jae Cheol Park
Eun Hye Oh
Yong Sik Yoon
Jong Lyul Lee
Jung Su Lee
Byong Duk Ye
Seung-Jae Myung
Nam Seok Ham
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

Details

ISSN :
15732568
Volume :
66
Issue :
9
Database :
OpenAIRE
Journal :
Digestive diseases and sciences
Accession number :
edsair.doi.dedup.....837ecc6ff7679df938c23467ed8fdb57