Background: Early endoscopic evaluation is recommended for assessment of postoperative recurrence (POR) of Crohn's disease (CD) but no further monitoring recommendations are available.
Aim: To evaluate the long-term outcome of patients without endoscopic POR at first endoscopic assessment.
Methods: Retrospective four-centre study including consecutive CD patients with ileocolonic resection (ICR) without endoscopic POR (Rutgeerts score i0-i1) at first endoscopic assessment performed within 18 months from ICR. All patients had a clinical follow-up ≥24 months and at least one further endoscopic assessment. Main outcomes were endoscopic, clinical and surgical POR, need for rescue therapy and "delayed POR" (any need for rescue therapy or clinical or surgical POR) during follow-up.
Results: Overall, 183 patients were included (79% with risk factors for POR, 44% without postoperative prophylaxis). Endoscopic POR was observed in 42% of patients. Clinical POR-free survival was 89.4% and 81.5% at 3 and 5 years, and delayed POR-free survival was 76.9% and 63.4% at 5 and 10 years, respectively. In multivariate analysis, postoperative prophylaxis (HR .55; 95% CI .325-.942) and active smoking (HR 1.72; 95%CI 1.003-2.962) were independent risk factors for clinical POR, whereas presence of mild endoscopic lesions at index ileocolonoscopy (i1) was the only risk factor for delayed POR (HR 1.824; 95% CI 1.108-3.002).
Conclusions: Long-term risk of POR among patients with no or mild endoscopic lesions at first ileocolonoscopy after surgery is steadily low, being higher among smokers, in the absence of postoperative prophylaxis and when mild endoscopic lesions are observed in the first endoscopic assessment.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/eci.14219 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Gastrointestinal symptoms and disorders of gut-brain interaction in pregnancy.
Indian J Gastroenterol
January 2025
Department of Gastroenterology, Criticare Asia Multispeciality Hospital and Research Centre, Mumbai, 400 049, India.
Gastrointestinal (GI) symptoms occur frequently in pregnant women, resulting in poor quality of life. These patients frequently require co-management with the obstetrician and a physician/GI specialist. The causation is complex and multifactorial.
View Article and Find Full Text PDFTracheal mucosal keratosis: Case discussion and literature review.
Chron Respir Dis
January 2025
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
A 57-year-old female presented with a chief complaint of cough, with productive yellow sputum particularly severe in the morning. Bronchoscopy revealed inflammatory changes in both main bronchi, with abundant white purulent secretions and necrotic material adhering to the luminal surface. Histopathological examination showed chronic inflammatory changes in the mucosal tissue, with mild hyperplasia of the local squamous epithelium and evidence of keratinization in the surrounding area, consistent with a diagnosis of tracheal mucosal keratosis.
View Article and Find Full Text PDFUreteral access sheath or percutaneous nephrostomy during flexible ureteroscopy: which is better?
Urolithiasis
January 2025
Urology Department, Benha University, Benha, Qalubia, Egypt.
Studies in literature discussed the drawbacks of the ureteral access sheath use in flexible ureteroscopy and in the same time mentioned the benefits of ureteral access sheath in decreasing the incidence of urosepsis and better stone free rate. In the current study we aim to compare between percutaneous nephrostomy tube (PCN) insertion before flexible ureteroscopy and conventional ureteral access sheath (UAS) flexible ureteroscopy in terms of safety, efficacy and perioperative outcomes. In all, 100 Patients aged 20 to 67 years with upper ureteric stones and mild hydronephrosis or renal pelvic stones less than 20 mm with mild hydronephrosis were randomized into 2 groups; patients undergoing PCN insertion before flexible ureteroscopy, and patients undergoing the conventional UAS flexible ureteroscopy.
View Article and Find Full Text PDFContemporary Algorithm for Treating Bromhidrosis: A Review of Treatment Available.
Aesthetic Plast Surg
January 2025
Department of Plastic Surgery, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Taijiang District, Fuzhou, China.
Bromhidrosis significantly impacts individuals' social, professional, and emotional well-being. Traditional treatments such as en bloc excision and alcohol injections are now less favored due to associated complications and suboptimal outcomes. Current evidence identifies botulinum toxin A (BTX-A) as the first-line treatment for mild to moderate cases (Grade 0-2), attributed to its high efficacy, excellent safety profile, and minimally invasive nature.
View Article and Find Full Text PDFGreater Fatigue and Reduced Neurocognitive Speed With Symptomatic Crohn's Disease.
Crohns Colitis 360
January 2025
Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Article Synopsis
- The study explored the link between Crohn's disease activity, fatigue, and neurocognitive function in adults, comparing 25 patients with Crohn's to 26 healthy controls.
- Patients with Crohn's disease reported significantly higher levels of fatigue, particularly when symptomatic, but showed no differences in neurocognitive accuracy or speed compared to healthy individuals.
- However, those with active Crohn's disease had slower response times in social cognition and episodic memory tasks, indicating a relationship between disease activity and cognitive processing, regardless of fatigue levels.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!