Postoperative Recurrence of Crohn's Disease: Pathophysiology, Diagnosis and Treatment

Sario, A. Di; Sassaroli, Paola; Daretti, L.M.; Annulli, G.; Schiadà, Laura; Falcioni, Giorgia; Bendia, E.; Antuono, S.; Benedetti, Antonio

doi:10.2174/1389201019666180216152805

Cited by 8 publications

(2 citation statements)

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“…Lastly, there has been interest in the interaction of the gut microbiome after intestinal resection and postoperative recurrence.. 20–22 A recent systematic review failed to draw unambiguous conclusions after evaluating studies on gut microbiota profiles, postoperative recurrence and postoperative microbial-based therapies in CD patients. 23 Some studies reported that postoperative treatment with low-dose metronidazole resulted in decreased postoperative endoscopic recurrence.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Recurrence or Anastomotic Wound Healing Phenomenon after Ileocolic Resection for Crohn’s Disease: The Challenges of Accurate Endoscopic Scoring

Willebois

Duijvestein

Wasmann

et al. 2022

Journal of Crohn's and Colitis

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Background and aims Adequate endoscopic scoring in Crohn’s disease (CD) is crucial, as dictates the need for initiating postoperative medical therapy and is utilized as outcome parameter in clinical trials. We aimed to observe anastomotic wound healing in relation to endoscopic scoring of both inverted and everted stapled lines in side-to-side anastomoses. Methods Two prospective patient cohorts were included: ileocolic resection (ICR) for CD, and right-sided colon resection for colorectal cancer (CRC). Videos taken during colonoscopy six months postoperatively were evaluated. The SES-CD and modified Rutgeerts score were determined. Primary outcome was the presence of ulcerations in CD patients on both the inverted and everted stapled lines. Secondary outcomes were the presence of anastomotic ulcerations in CRC patients and the number of cases having ulcerations exclusively at the inverted stapled line. Results Of the 82 patients included in the CD cohort, ulcerations were present in 63/82 (76·8%) at the inverted- versus 1/71 (1·4%) at the everted stapled line. Likewise in the CRC cohort, ulcerations were present in 4/6 (67·7%) at the inverted versus 0/6 (0%) at the everted stapled line. 27% of the 63 patients in the CD cohort had ulcerations exclusively on the inverted stapled line. Conclusion Inverted stapled lines heal with ulcerations, whereas the everted stapled line heal without any ulcerations, both in CD and non-CD patients. The abnormalities at the inverted stapled line might interfere with endoscopic scoring of recurrence, with potentially an impact on patients’ quality of life and on health-care costs if postoperative treatment is initiated incorrectly.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Recurrence or Anastomotic Wound Healing Phenomenon after Ileocolic Resection for Crohn’s Disease: The Challenges of Accurate Endoscopic Scoring

Willebois

Duijvestein

Wasmann

et al. 2022

Journal of Crohn's and Colitis

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“…Unfortunately, despite developments in the management and treatment of CD over the years, about 80% of patients still require surgery at some point, with approximately 70% developing postoperative recurrence within 12 months [ 34 ]. This is even further complicated as patients with these recurrences carry a worse prognosis [ 35 ].…”

Section: Reviewmentioning

confidence: 99%

The Role of Capsule Endoscopy in Crohn's Disease: A Review

Odeyinka¹,

Alhashimi²,

Thoota³

et al. 2022

Cureus

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Crohn's disease (CD) is a chronic inflammatory disorder with a predilection for the small bowel. Although awareness of this disorder has increased over the years, it remains a diagnostic challenge for many physicians. This is exacerbated by the rising incidence and high recurrence rate following therapy in certain individuals. It is currently agreed that a multimodality approach is the best one, but with the advent of new modalities, that could be changing. Furthermore, given its impact on the mental health of patients and the cost of treatment, it is pertinent that we arrive at not only convenient but accurate modalities in its diagnosis and management. Among these investigative modalities is the relatively novel capsule endoscopy (CE) that not only provides a more patient-friendly alternative but avoids the need for invasiveness. Asides from its diagnostic capability, its influence on therapy and monitoring of known CD patients following treatment has been shown. This article has reviewed the current literature comparing the relevance of CE with other available modalities in diagnosing CD patients. We explored its therapeutic impact and how it influences monitoring post-treatment in CD. This article also discusses the complications of CE and the possible solutions to these complications in the future.

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Preoperative computed tomography enterography-based radiomics signature: A potential predictor of postoperative anastomotic recurrence in patients with Crohn’s disease

Shen

Zhang

Huang

et al. 2023

European Journal of Radiology

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Postoperative Recurrence of Crohn's Disease: Pathophysiology, Diagnosis and Treatment

Abstract: Therefore, stratifying patients according to their risk of recurrence and tailoring therapy are at present the ideal and most cost-effective ways to treat operated CD patients, although many aspects require further evaluation.

Cited by 8 publications

References 0 publications

Endoscopic Recurrence or Anastomotic Wound Healing Phenomenon after Ileocolic Resection for Crohn’s Disease: The Challenges of Accurate Endoscopic Scoring

Endoscopic Recurrence or Anastomotic Wound Healing Phenomenon after Ileocolic Resection for Crohn’s Disease: The Challenges of Accurate Endoscopic Scoring

The Role of Capsule Endoscopy in Crohn's Disease: A Review

Preoperative computed tomography enterography-based radiomics signature: A potential predictor of postoperative anastomotic recurrence in patients with Crohn’s disease

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