Long-term clinical results of ileocecal resection for Crohnʼs disease

Cullen, Garret; O’Toole, Aoibhlinn; Keegan, Denise; Sheahan, Kieran; Hyland, John; O’Donoghue, Diarmuid

doi:10.1002/ibd.20220

Cited by 64 publications

(59 citation statements)

References 14 publications

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“…Bernell et al [5] observed that postoperative recurrence occurred in 33% and 44% of patients at 5 and 10 years after resection, respectively. Similar to these results, Cullen et al [11] observed that the relapse rate was 35%. The relapse rate was relatively low in our study.…”

Section: Discussionsupporting

confidence: 72%

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Clinical literature review of 1858 Crohn's disease cases requiring surgery in China

Peng

Zhang

et al. 2015

WJG

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Section: Discussionsupporting

confidence: 72%

“…The mean age was 38.13 years in our study. Whereas in the Western countries, the mean age was reported to be 32 years [5] and 28.7 years [11] . The average age of surgery from most reports in Western countries is lower than in our study.…”

Section: Discussionmentioning

confidence: 99%

Clinical literature review of 1858 Crohn's disease cases requiring surgery in China

Peng

Zhang

et al. 2015

WJG

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“…Alkalmazott immunmoduláns és biológiai kezelés, sebészeti beavatkozások gyakorisága, valamint aktivitási indexek az egyéves kontroll idején [6,15,16]. Freeman és munkatársai 1015 CD-s beteg adatait elemezték, az átlagos követési idő több mint 10 év volt, és 247 betegnél találtak granulomát.…”

Section: Táblázatunclassified

“…Cullen és munkatársai 139, ileocaecalis reszekción átesett felnőtt beteg 48%-ában találtak granulomát. A granulomás csoportban a relapsusok és az ismételt reszekciós műtétek szignifi kánsan gyakoribbak voltak [15]. Markowitz és munkatársai 56 gyermek CD-s kö-vetése során szintén gyakoribbnak találták a műtéti beavatkozások szükségességét a granulomás csoportban [8].…”

Section: Táblázatunclassified

Frequency and characteristics of granulomas in 368 pediatric patients with Crohn’s disease

et al. 2013

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Bevezetés: A granulomák kulcsszerepet töltenek be a gyulladásos bélbetegségek diagnosztikájában. Nem tisztázott azonban jelentőségük a Crohn-betegség patogenezisében és klinikai megjelenésében. Célkitűzés: A szerzők célul tűzték ki a granulomák gyakoriságának és jelentőségének meghatározását a Magyar Gyermekkori Gyulladásos Bél-betegség Regiszter alapján. Módszer: 2007. január 1. és 2010. december 31. között 368 Crohn-beteg adatait elemezték. Eredmények: A granulomák gyakorisága a diagnóziskor 31,4% (111/353) volt. A granulomák izolált megjelenése a felső gastrointestinalis rendszerben 2,5%, a terminalis ileumban 5% volt. A granulomás és a nem granulomás csoport között nem volt eltérés a fenotípusban és aktivitási indexben. Az immunmoduláns és a biológiai kezelés gyakorisága hasonló volt a két csoportban. Következtetések: A granulomák gyakorisága hazánkban megegyezik a nemzetközi tapasztalatokkal. Kiemelendő, hogy a terminalis ileumban vagy a felső gastrointestinalis rendszerben izoláltan talált granulomák 13 Crohn-beteg gyermekből egynél járultak hozzá a diagnózis felállításához. Ezek az adatok felhívják a fi gyelmet arra, hogy a béltraktus minden szegmenséből vett többszörös biopsziás mintavétel a diagnózis felállításához nélkülözhetetlen. Orv. Hetil., 2013, 154, 1702-1708

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“…1, 2), early resection can produce the same mucosal healing one expects to achieve with aggressive medical therapy. However, the recurrence-free interval is likely to be longer (as demonstrated by studies of patients who have undergone surgery relatively early for acute presentations or for early onset perforation) [24,25]. Early surgical intervention in patients with B1 disease and short-segment lesions allows one to perform simple procedures, which can be carried out with minimally invasive techniques and without the increased risk of complications (postoperative infections in particular) associated with surgical treatment of more complex disease (B3) (Fig.…”

Section: Epidemiologymentioning

confidence: 99%

Surgery and diagnostic imaging in abdominal Crohn’s disease

et al. 2013

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Surgery is well-established option for the treatment of Crohn's disease that is refractory to medical therapy and for complications of the disease, including strictures, fistulas, abscesses, bleeding that cannot be controlled endoscopically, and neoplastic degeneration. For a condition like Crohn's disease, where medical management is the rule, other indications for surgery are considered controversial, because the therapeutic effects of surgery are limited to the resolution of complications and the rate of recurrence is high, especially at sites of the surgical anastomosis. In the authors' opinion, however, surgery should not be considered a last-resort treatment: in a variety of situations, it should be regarded as an appropriate solution for managing this disease. Based on a review of the literature and their own experience, the authors examine some of the possibilities for surgical interventions in Crohn's disease and the roles played in these cases by diagnostic imaging modalities.Riassunto La chirurgia è un'opzione terapeutica consolidata per il trattamento della malattia di Crohn refrattaria alla terapia medica e per le complicanze legate a tale patologia quali stenosi, fistole, ascessi, sanguinamento non trattabile endoscopicamente, oltre che per i casi di degenerazione neoplastica. Per condizioni come la malattia di Crohn nelle quali il trattamento medico ha un ruolo primario, altre indicazioni per la chirurgia sono controverse, poiché i suoi effetti terapeutici sono limitati alla risoluzione delle complicanze, e la frequenza di recidive è alta, soprattutto a livello dell'anastomosi. Secondo l'opinione degli autori, tuttavia, la chirurgia non deve essere considerata come ultima opzione di trattamento: in diverse situazioni dovrebbe essere ritenuta come una soluzione adeguata nel trattamento multidisciplinare della patologia. Basandosi sulla revisione della letteratura corrente e sulla propria esperienza, gli autori hanno esaminato alcune possibilità di intervento chirurgico nella malattia di Crohn ed il ruolo che svolgono in queste condizioni le tecniche di imaging.

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Long-term clinical results of ileocecal resection for Crohnʼs disease

Abstract: Long-term outcomes for ileocecal resection in CD are excellent with 48% of patients remaining symptom-free and only 35% requiring repeat resection surgery at 10 years. This should be borne in mind when considering biologic therapy.

Cited by 64 publications

References 14 publications

Clinical literature review of 1858 Crohn's disease cases requiring surgery in China

Clinical literature review of 1858 Crohn's disease cases requiring surgery in China

Frequency and characteristics of granulomas in 368 pediatric patients with Crohn’s disease

Surgery and diagnostic imaging in abdominal Crohn’s disease

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