Repeated surgery for recurrent Crohn’s disease: does the outcome keep worsening operation after operation? A comparative study of 1224 consecutive procedures

Colombo, Francesco; Frontali, Alice; Cigognini, Maria; Lamperti, Giulia; Manzo, Carlo Alberto; Maconi, Giovanni; Ardizzone, Sandro; Foschi, Diego; Sampietro, Gianluca

doi:10.1007/s13304-021-01187-0

Cited by 10 publications

(6 citation statements)

References 44 publications

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“…Therefore, surgery is still often necessitated; 25-33% of patients require surgery within five years after biological therapy [26]. Since surgical treatment is not curative in IBD, post-operation recurrence and repeated surgery rates remain high [26,27]. Furthermore, biological therapies are expensive, require repeated intravenous infusions or subcutaneous injections, and carry long-term safety concerns, including the potential development of congestive heart failure, skin lesions, immune reactions, increased susceptibility to infections and cancers, and decreased fertility/adverse effects on pregnancy [22,28].…”

Section: Introductionmentioning

confidence: 99%

Krill Oil and Its Bioactive Components as a Potential Therapy for Inflammatory Bowel Disease: Insights from In Vivo and In Vitro Studies

Liu,

Robinson,

et al. 2024

Biomolecules

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Krill oil is extracted from krill, a small crustacean in the Antarctic Ocean. It has received growing attention because of krill oil’s unique properties and diverse health benefits. Recent experimental and clinical studies suggest that it has potential therapeutic benefits in preventing the development of a range of chronic conditions, including inflammatory bowel disease (IBD). Krill oil is enriched with long-chain n-3 polyunsaturated fatty acids, especially eicosapentaenoic and docosahexaenoic acids, and the potent antioxidant astaxanthin, contributing to its therapeutic properties. The possible underlying mechanisms of krill oil’s health benefits include anti-inflammatory and antioxidant actions, maintaining intestinal barrier functions, and modulating gut microbiota. This review aims to provide an overview of the beneficial effects of krill oil and its bioactive components on intestinal inflammation and to discuss the findings on the molecular mechanisms associated with the role of krill oil in IBD prevention and treatment.

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Section: Introductionmentioning

confidence: 99%

Krill Oil and Its Bioactive Components as a Potential Therapy for Inflammatory Bowel Disease: Insights from In Vivo and In Vitro Studies

Liu,

Robinson,

et al. 2024

Biomolecules

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“…In addition to these, in most cases, the administration of immunosuppressors and biologic therapies fails to control the natural course of the disease [5,6]; indeed, almost 80% of CD patients will ultimately be submitted to bowel resection [3]. However, removing the affected bowel segment is not curative and, due to 50% clinical recurrence rates, many patients will require multiple resections [3,7].…”

Section: Introduction 1rationalementioning

confidence: 99%

The Reduction of Anastomosis-Related Morbidity Using the Kono-S Anastomosis in Patients with Crohn’s Disease: A Meta-Analysis

Baloyiannis,

Perivoliotis,

Sarakatsianou

et al. 2024

JCM

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(1) Background: we conducted this study to evaluate the effect of Kono-S anastomosis on postoperative morbidity after bowel resection for Crohn’s disease. (2) Methods: This study adhered to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The primary endpoint was the overall complications rate. Secondary outcomes included specific complications analyses, disease recurrence and efficiency endpoints. A systematic literature screening was performed in major electronic scholar databases (Medline, Scopus, Web of Science), from inception to 17 January 2024. Both Random (RE) and Fixed Effects (FE) models were estimated; the reported analysis was based on the Cochran Q test results. (3) Results: Overall, eight studies and 913 patients were included in this meta-analysis. Pooled analyses confirmed that Kono-S was not superior in terms of overall morbidity (OR: 0.69 [0.42, 1.15], p = 0.16). Kono-S displayed a reduced risk for anastomotic leakage (OR: 0.34 [0.16, 0.71], p = 0.004) and reoperation (OR: 0.12 [0.05, 0.27], p < 0.001), and a shortened length of hospital stay (WMD: −0.54 [−0.73, −0.34], p < 0.001). On the contrary, Kono-S results in higher rates of postoperative SSIs (OR: 1.85 [1.02, 3.35], p = 0.04). (4) Conclusions: This study confirms a comparable morbidity, but a lower risk of anastomotic leak and reoperation of Kono-S over conventional anastomoses. Further high quality studies are required to validate these findings.

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“…Transmural inflammation of the gastrointestinal tract alternates between chronic remission and recurrence [ 3 ]. These characteristics leave patients with chronic immunosuppression and they need repeated surgery to treat the symptoms of the disease [ 4 , 5 ], but surgery cannot cure the disease [ 6 ]. More than a quarter of patients with CD develop perianal fistulizing Crohn’s disease (PFCD) [ 7 ], which has been treated with biologics and surgical procedures [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Internal Orifice Alloy Closure: A New Procedure for Treatment of Perianal Fistulizing Crohn’s Disease

Fang,

Deng,

2023

Med Sci Monit

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Background The high recurrence rate of perianal fistula Crohn’s disease (PFCD) increases the need to protect the anal sphincter during each surgical treatment of fistulas. We aimed to evaluate the safety and efficacy of internal orifice alloy closure in patients with PFCD. Material/Methods Fifteen patients with PFCD were enrolled in the study between July 6, 2021, and April 27, 2023. All patients underwent preoperative colonoscopy and anal magnetic resonance examination for diagnosis and evaluation. Internal orifice alloy closure (IOAC) was performed only when Crohn’s disease was in remission. The external sphincter had not been severed. Perianal magnetic resonance imaging examination was used for postoperative evaluation after 6 months. Fistula cure rate, length of stay, perianal pain, and Wexner incontinence score were retrospectively compared between 15 patients treated with IOAC and 40 patients treated with other surgical methods. Results Fifteen patients (male/female: 9/6, age: 23.6±14.3 years) with PFCD were included (follow-up: 24 months). In total, 20.0% (3) had multiple tracts, and 13.3% (2) had a high anal fistula. Among them, 10 patients received biologics for induction for mucosal healing before surgery. The fistula healed completely in 80.0% (12/15) and did not heal in 20.0% (3/15). Three patients who did not heal underwent fistulotomy and eventually recovered. IOAC is not superior in terms of fistula healing rates, length of stay, and anal pain, but its Wexner incontinence scores are significantly lower than with other surgical methods. Conclusions IOAC is a novel sphincter-saving surgery that is effective and safe for the treatment of PFCD.

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Repeated surgery for recurrent Crohn’s disease: does the outcome keep worsening operation after operation? A comparative study of 1224 consecutive procedures

Cited by 10 publications

References 44 publications

Krill Oil and Its Bioactive Components as a Potential Therapy for Inflammatory Bowel Disease: Insights from In Vivo and In Vitro Studies

Krill Oil and Its Bioactive Components as a Potential Therapy for Inflammatory Bowel Disease: Insights from In Vivo and In Vitro Studies

The Reduction of Anastomosis-Related Morbidity Using the Kono-S Anastomosis in Patients with Crohn’s Disease: A Meta-Analysis

Internal Orifice Alloy Closure: A New Procedure for Treatment of Perianal Fistulizing Crohn’s Disease

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