Predictability of the postoperative course of Crohn's disease

Rutgeerts, Paul; Geboes, Karel; Vantrappen, Gaston; Beyls, Jan; Kerremans, Raymond; Hiele, Martin

doi:10.1016/0016-5085(90)90613-6

Cited by 1,612 publications

(1,268 citation statements)

References 19 publications

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“…We have previously reported similar results [3]. During 6-month treatment, endoscopic lesions (Rutgeerts score [2] C2 at 6 months after resection) were improved in 75% of patients (including 38% with complete mucosal healing) treated with infliximab versus none of the patients treated with mesalamine. In both studies [1,3], infliximab significantly reduced clinical recurrence.…”

supporting

confidence: 68%

“…Furthermore, these parameters are of limited use to identify patients at high risk of recurrence and to establish prophylactic strategy for postoperative recurrence. In contrast, the severity of endoscopic inflammation in the early postoperative period is a reliable risk factor for recurrence [2]. Patients with severe endoscopic lesions develop early clinical recurrence.…”

mentioning

confidence: 99%

“…In their prospective study, patients with endoscopic recurrence (Rutgeerts score [2] C2) at 6 months after resection were treated with infliximab or mesalamine. At week 54, infliximab significantly improved endoscopic lesions including 54% with endoscopic remission.…”

mentioning

confidence: 99%

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Infliximab for Early Endoscopic Recurrence in Patients with Crohn’s Disease

Yamamoto

2012

Dig Dis Sci

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supporting

confidence: 68%

mentioning

confidence: 99%

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Infliximab for Early Endoscopic Recurrence in Patients with Crohn’s Disease

Yamamoto

2012

Dig Dis Sci

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“…Capsule endoscopy provides meaningful information on the inflammatory burden in the small bowel mucosa, similarly to the role of conventional ileocolonoscopy for the colon and the terminal ileum. Bowel stenosis should be ruled [81] 35 77% 20% 47% < 0.05 Hara et al [82] 17 71% 53% 18% NA Voderholzer et al [83] 41 61% 49% (CT enteroclysis) 12% < 0.04 Solem et al [84] 40 83% 83% 0 NS MRE Albert et al [85] 27 93% 78% 15% NS Crook et al [22] 19 93% 71% 18% NS Jensen et al [20] 93 100% 86% 14% NS Ileocolonoscopy Hara et al [82] 17 71% 65% 6% NS Solem et al [84] 40 83% 74% 9% NS Leighton et al [86] 80 be demonstrated in 73%-93% of the patients within 1 year of ileocolonic resection [29,30] . SB lesions associated with postoperative recurrence are frequently quantified using the Rutgeerts score [29] .…”

Section: Vce In Established CDmentioning

confidence: 99%

Role of capsule endoscopy in inflammatory bowel disease

Leighton

Legnani

Seidman

2007

Inflammatory Bowel Diseases

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Videocapsule endoscopy (VCE) has revolutionized our ability to visualize the small bowel mucosa. This modality is a valuable tool for the diagnosis of obscure small bowel Crohn's disease (CD), and can also be used for monitoring of disease activity in patients with established small-bowel CD, detection of complications such as obscure bleeding and neoplasms, evaluation of response to anti-inflammatory treatment and postoperative recurrence following small bowel resection. VCE could also be an important tool in the management of patients with unclassified inflammatory bowel disease, potentially resulting in reclassification of these patients as having CD. Reports on postoperative monitoring and evaluation of patients with ileal pouch-anal anastomosis who have developed pouchitis have recenty been published. Monitoring of colonic inflammatory activity in patients with ulcerative colitis using the recently developed colonic capsule has also been reported. Capsule endoscopy is associated with an excellent safety profile. Although retention risk is increased in patients with small bowel CD, this risk can be significanty decreased by a routine utilization of a dissolvable patency capsule preceding the ingestion of the diagnostic capsule. This paper contains an overview of the current and future WJG 20 th Anniversary Special Issues (3): Inflammatory bowel disease TOPIC HIGHLIGHTclinical applications of capsule endoscopy in inflammatory bowel disease.

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“…Even though longer postoperative remission periods are reported for children, most studies have monitored clinical recurrence rates instead of endoscopic follow-up [2,[12][13][14][15]. As clinical symptoms are frequently absent and serum biochemical markers normal until significant inflammatory changes have developed, ileocolonoscopy with histological verification should be considered as the gold standard for assessing disease activity and postoperative recurrence [6,[8][9][10]16].…”

mentioning

confidence: 99%

Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

Hukkinen

Pakarinen

Merras‐Salmio

et al. 2016

Journal of Pediatric Surgery

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a b s t r a c t a r t i c l e i n f oBackground: Fecal calprotectin (FC) correlates with endoscopic recurrence of Crohn's disease (CD) in adults but has not been studied among children postoperatively. We aimed to analyze whether FC relates with postoperative CD recurrence in children. Methods: Altogether 51 postoperative endoscopies and FC measurements from 22 patients having undergone surgery for CD at age ≤18 years were included. Results: Ileocecal resection (n = 15), small bowel resection (n = 6), or left hemicolectomy (n = 1) was performed at median age of 15.1 (interquartile range 14.4-17.6) years. Following surgery, FC decreased significantly (659 vs. 103 μg/g, p = 0.001). During median follow-up of 5.7 (4.2-7.7) years, either endoscopic or histological recurrence occurred in 17 patients (77%). FC N139 μg/g at time of endoscopy or FC increase of 79 μg/g compared to first postoperative value was suggestive of endoscopic recurrence (Rutgeerts score i2-i4), while FC N101 μg/g or increase of 21 μg/g indicated histological recurrence. Best accuracy for prediction of recurrence was obtained by combining FC at endoscopy and the postoperative increase of FC. The corresponding AUROC values were 0.74 (95% 0.58-0.89) for endoscopic recurrence whereas 0.81 (95% CI 0.67-0.95) for histological recurrence. Conclusion: FC is a useful surrogate marker of postoperative recurrence also in pediatric CD patients.

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Predictability of the postoperative course of Crohn's disease

Cited by 1,612 publications

References 19 publications

Infliximab for Early Endoscopic Recurrence in Patients with Crohn’s Disease

Infliximab for Early Endoscopic Recurrence in Patients with Crohn’s Disease

Role of capsule endoscopy in inflammatory bowel disease

Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

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