Effect of anastomotic configuration on Crohn’s disease recurrence after primary ileocolic resection: a comparative monocentric study of end-to-end versus side-to-side anastomosis

Bislenghi, Gabriele; Vancoillie, Peter-Jan; Fieuws, Steffen; Verstockt, Bram; Sabino, J; Wolthuis, Albert; D’Hoore, André

doi:10.1007/s13304-023-01561-0

Cited by 8 publications

(7 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the 22 articles, 12 were from Europe [ 13 , 18 – 20 , 22 – 25 , 30 , 36 ], 4 from North America [ 21 , 26 , 27 , 29 ], 5 from Asia [ 14 , 15 , 28 , 34 , 35 ], and 1 from South America [ 17 ]. 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.…”

Section: Resultsmentioning

confidence: 99%

“…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%

See 2 more Smart Citations

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

View full text Add to dashboard Cite

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).

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Basic Featuresmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

show abstract

“…In recent years, several papers have been published related to the different outcomes of patients with i2a vs. i2b lesions [ 25 , 26 , 27 ] without consistent findings; consequently, it is still unclear whether i2a and i2b findings should be treated and monitored differently. Recent advances in surgical approaches and different anastomotic techniques have highlighted the importance of considering various operative factors and led to the development of different surgical options, each with a different risk of POR [ 28 , 29 , 30 ]. Evidence indicates stapled intestinal anastomoses, whether side-to-side or end-to-end, demonstrate superior outcomes relative to hand-sewn techniques (anastomotic leak rate of 2% vs. 14%) [ 31 , 32 ].…”

Section: Monitoringmentioning

confidence: 99%

The Management of Postoperative Recurrence in Crohn’s Disease

Fasulo,

D’Amico,

Osorio

et al. 2023

JCM

View full text Add to dashboard Cite

Crohn’s disease (CD) is a chronic inflammatory bowel disease with different phenotypes of presentation, inflammatory, penetrating, or stricturing disease, that significantly impacts patient well-being and quality of life. Despite advances in medical therapy, surgery sometimes represents the only treatment to address complications, such as strictures, fistulas, or abscesses. Minimizing postoperative recurrence (POR) remains a major challenge for both clinicians and patients; consequently, various therapeutic strategies have been developed to prevent or delay POR. The current review outlines an updated overview of POR management. We focused on diagnostic assessment, which included endoscopic examination, biochemical analyses, and cross-sectional imaging techniques, all crucial tools used to accurately diagnose this condition. Additionally, we delved into the associated risk factors contributing to POR development. Furthermore, we examined recent advances in the prophylaxis and treatment of POR in CD.

show abstract

“…To overcome this concern, various strategies have been evaluated to decrease rates of local disease recurrence. While one aspect represents the creation of the anastomosis, neither different orientations nor technical aspects showed advantages for one or the other strategy so far 11 , 12 . In contrast, novel concepts such as the Kono-S anastomosis or extended resection of the mesenterium demonstrate promising results to potentially decrease rates of the disease recurrence 11 , 13 , 14 , however, those strategies still need to be confirmed in ongoing prospective randomized trials.…”

Section: Introductionmentioning

confidence: 99%

Positive resection margins in Crohn’s disease are a relevant risk factor for postoperative disease recurrence

Kelm,

Benatzky,

Buck

et al. 2024

Sci Rep

View full text Add to dashboard Cite

Postoperative disease recurrence in Crohn’s disease represents a relevant issue despite recent advancements in surgical and medical therapies. Additional criteria are necessary to improve the identification of patients at risk and to enable selective therapeutic approaches. The role of resection margins on disease recurrence remains unclear and general recommendations are lacking. A single-center retrospective analysis was performed including all patients who received ileocecal resection due to Crohn’s disease. Resection margins were analyzed by two independent pathologists and defined by histopathological criteria based on previous consensus reports. 158 patients were included for analysis with a median follow up of 35 months. While postoperative morbidity was not affected, positive resection margins resulted in significantly increased rates of severe endoscopic recurrence at 6 months (2.0% versus 15.6%, p = 0.02) and overall (4.2% versus 19.6%, p = 0.001), which resulted in significantly increased numbers of surgical recurrence (0% versus 4.5%, p = 0.04). Additionally, positive margins were identified as independent risk factor for severe endoscopic disease recurrence in a multivariate analysis. Based on that, positive margins represent an independent risk factor for postoperative endoscopic and surgical disease recurrence. Prospective studies are required to determine whether extended resection or postoperative medical prophylaxis is beneficial for patients with positive resection margins.

show abstract

Effect of anastomotic configuration on Crohn’s disease recurrence after primary ileocolic resection: a comparative monocentric study of end-to-end versus side-to-side anastomosis

Cited by 8 publications

References 23 publications

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

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

The Management of Postoperative Recurrence in Crohn’s Disease

Positive resection margins in Crohn’s disease are a relevant risk factor for postoperative disease recurrence

Contact Info

Product

Resources

About