Residual Lesions on Capsule Endoscopy Is Associated with Postoperative Clinical Recurrence in Patients with Crohn’s Disease

Kusaka, Jun; Shiga, Hisashi; Kuroha, Masatake; Kimura, Tsutomu; Kakuta, Yoichi; Endo, Katsuya; Kinouchi, Yoshitaka; Shimosegawa, Tooru

doi:10.1007/s10620-018-4942-6

Cited by 14 publications

(16 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is reinforced by the results of another study that aimed to assess residual SB lesions in 25 CD patients immediately after surgery (< 3 mo). The mean Lewis score was 751.3, and 84.0% had endoscopic activity, and these residual lesions, especially in the distal SB, were associated with postoperative clinical recurrence[55], suggesting that SBCE could be used to detect very early post-operative recurrence, particularly in patients without any risk factors who do not necessarily require prophylactic treatment according to the current guidelines.…”

Section: Resultsmentioning

confidence: 99%

“…This review demonstrated that SBCE could effectively detect post-operative recurrence to a similar extent as ileocolonoscopy, and that it can detect proximal SB lesions beyond the reach of the colonoscope in more than half of the patients[49,51]. SBCE could be used to detect very early post-operative recurrence especially in patients without any risk factors who do not necessarily require pharmacological prophylaxis immediately after surgery[54,55].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Small bowel capsule endoscopy and treat-to-target in Crohn's disease: A systematic review

Berre¹,

Trang-Poisson²,

Bourreille³

2019

WJG

View full text Add to dashboard Cite

BACKGROUND Crohn’s disease (CD) can affect the entire gastrointestinal tract. Proximal small bowel (SB) lesions are associated with a significant risk of stricturing disease and multiple abdominal surgeries. The assessment of SB in patients with CD is therefore necessary because it may have a significant impact on prognosis with potential therapeutic implications. Because of the weak correlation that exists between symptoms and endoscopic disease activity, the “treat-to-target” paradigm has been developed, and the associated treatment goal is to achieve and maintain deep remission, encompassing both clinical and endoscopic remission. Small bowel capsule endoscopy (SBCE) allows to visualize the mucosal surface of the entire SB. At that time, there is no recommendation regarding the use of SBCE during follow-up. AIM To investigate the impact of SBCE in a treat-to-target strategy in patients with CD. METHODS An electronic literature search was conducted in PubMed and Cochrane library using the following search terms: “capsule endoscopy”, in combination with “Crohn’s disease” and “treat-to-target” or synonyms. Two authors independently reviewed titles and abstracts identified by the search strategy after duplicates were removed. Following the initial screening of abstracts, all articles containing information about SBCE in the context of treat-to-target strategy in patients with CD were included. Full-text articles were retrieved, reference lists were screened manually to identify additional studies. RESULTS Forty-seven articles were included in this review. Two indexes are currently used to quantify disease activity using SBCE, and there is good correlation between them. SBCE was shown to be useful for disease reclassification in patients who are suspected of having or who are diagnosed with CD, with a significant incremental diagnostic yield compared to other diagnostic modalities. Nine studies also demonstrated that the mucosal healing can be evaluated by SBCE to monitor the effect of medical treatment in patients with CD. This review also demonstrated that SBCE can detect post-operative recurrence to a similar extent as ileocolonoscopy, and proximal SB lesions that are beyond the reach of the colonoscope in over half of the patients. CONCLUSION SBCE could be incorporated in the treat-to-target algorithm for patients with CD. Randomized controlled trials are required to confirm its usefulness and reliability in this indication.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Small bowel capsule endoscopy and treat-to-target in Crohn's disease: A systematic review

Berre¹,

Trang-Poisson²,

Bourreille³

2019

WJG

View full text Add to dashboard Cite

show abstract

“…The cumulative CPOR rate was significantly higher in patients with the highest third tertile score (p = 0.046) [28]. Residual lesions after surgery, especially in the distal small intestine were associated with higher rates of CPOR, thus reinforcing the concept that those lesions are clinically significant and that early detection of EPOR is crucial to prevent CPOR [28]. In a retrospective cohort study by Han et al [30], a group of 37 patients underwent IC with WCE (group 1) after 1 year of surgery and another group of 46 patients (group 2) underwent IC only.…”

Section: Hausmann Et Al Conducted a Prospective Multicenter Pilot Study Comparing Panintestinal Wce With Ic For The Detection Of Por In Cmentioning

confidence: 96%

Wireless Capsule Endoscopy for Diagnosis and Management of Post-Operative Recurrence of Crohn’s Disease

Mir

Nguyen

Soliman

et al. 2021

Life

View full text Add to dashboard Cite

Despite aggressive medical therapy, many patients with Crohn’s disease require surgical intervention over time. After surgical resection, disease recurrence is common. Ileo-colonoscopy and the Rutgeerts score are commonly used for diagnosis and monitoring of post-operative endoscopic recurrence. The latter is the precursor of clinical recurrence and therefore it impacts prognosis and patient management. However, due to the limited length of bowel assessed by ileo-colonoscopy, this procedure can miss out-of-reach, more proximal lesions in the small bowel. This limitation introduces an important uncertainty when evaluating post-operative relapse by ileo-colonoscopy. In addition, the Rutgeerts score ‘per se’ bears a number of ambiguities. Here we will discuss the pros and cons of ileo-colonoscopy and other imaging studies including wireless capsule endoscopy to diagnose and manage post-operative recurrence of Crohn’s disease. A number of studies provide evidence that wireless capsule endoscopy is a potentially more accurate as well as less invasive and less costly alternative to conventional techniques including ileo-colonoscopy.

show abstract

“…Thanks to the wide implementation of SB patency tests (patency capsule or entero‐MR/CT), in recent studies, the risk of capsule retention has remarkably decreased (up to 2.5% in established Crohn's disease) . In parallel, CE assessment of disease severity and extent in the SB has emerged as a valid diagnostic target for patients with a new diagnosis of Crohn's disease, irrespective of the findings at ileocolonoscopy, and as a reliable tool for longitudinal monitoring in the era of treat‐to‐target strategies . The advent of capsule devices with a prolonged operating time has recently opened the era of pan‐intestinal CE .…”

Section: Enteroscopy: a Powerful Weapon To Solve Big Problems In The mentioning

confidence: 99%

“…155 In parallel, CE assessment of disease severity and extent in the SB has emerged as a valid diagnostic target for patients with a new diagnosis of Crohn's disease, irrespective of the findings at ileocolonoscopy, 156 and as a reliable tool for longitudinal monitoring in the era of treat-to-target strategies. [157][158][159][160][161][162] The advent of capsule devices with a prolonged operating time has recently opened the era of pan-intestinal CE. 159,162 This all-in-one and on-demand approach has a promising application in IBD 159,[162][163][164][165] where it can supposedly speed up the diagnostic work-up and decrease the need for endoscopic procedures.…”

Section: Capsule Enteroscopymentioning

confidence: 99%

Endoscopic ultrasonography and small‐bowel endoscopy: Present and future

Tontini

Manfredi

Orlando

et al. 2019

Digestive Endoscopy

View full text Add to dashboard Cite

Over the last decade, impressive technological advances have occurred in ultrasonography and small‐bowel endoscopy. Nowadays, endoscopic ultrasonography is an essential diagnostic tool and a therapeutic weapon for pancreatobiliary disorders. Capsule endoscopy and device‐assisted enteroscopy have quickly become the reference standard for the diagnosis of small‐bowel luminal diseases, thereby leading to radical changes in diagnostic and therapeutic pathways. We herein provide an up‐to‐date overview of the latest advances in endoscopic ultrasonography and small‐bowel endoscopy, focusing on the emerging paradigms and technological innovations that might improve clinical practice in the near future.

show abstract

Residual Lesions on Capsule Endoscopy Is Associated with Postoperative Clinical Recurrence in Patients with Crohn’s Disease

Abstract: Many cases with CD had endoscopic activity immediately after "curative" surgery. These residual lesions, especially in the distal small intestine, were associated with postoperative clinical recurrence.

Cited by 14 publications

References 21 publications

Small bowel capsule endoscopy and treat-to-target in Crohn's disease: A systematic review

Small bowel capsule endoscopy and treat-to-target in Crohn's disease: A systematic review

Wireless Capsule Endoscopy for Diagnosis and Management of Post-Operative Recurrence of Crohn’s Disease

Endoscopic ultrasonography and small‐bowel endoscopy: Present and future

Contact Info

Product

Resources

About