Factors affecting the incidence of early endoscopic recurrence after ileocolonic resection for Crohn's disease: a multicentre observational study

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dc.contributor.authorde Barcelos, I. F.
dc.contributor.authorKotze, P. G.
dc.contributor.authorSpinelli, A.
dc.contributor.authorSuzuki, Y.
dc.contributor.authorTeixeira, F. V.
dc.contributor.authorde Albuquerque, I. C.
dc.contributor.authorSaad-Hossne, R. [UNESP]
dc.contributor.authorda Silva Kotze, L. M.
dc.contributor.authorYamamoto, T.
dc.contributor.institutionCatholic University of Paraná
dc.contributor.institutionHumanitas Research Hospital
dc.contributor.institutionToho University Sakura Medical Centre
dc.contributor.institutionGastrosaude Outpatient Clinic
dc.contributor.institutionHeliopolis Hospital
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionYokkaichi Hazu Medical Centre
dc.date.accessioned2018-12-11T17:30:52Z
dc.date.available2018-12-11T17:30:52Z
dc.date.issued2017-01-01
dc.description.abstractAim: Early endoscopic recurrence is frequently observed in patients following resection for Crohn's disease (CD). However, factors affecting the incidence of an early postoperative endoscopic recurrence (EPER) have not been fully determined. The aim of this study was to evaluate risk factors for EPER after ileocolonic resection for CD. Method: This was a retrospective, international multicentre study, in which 127 patients with a first ileocolonoscopy conducted between 6 and 12 months after ileocolonic resection for CD were included. Endoscopic recurrence was defined as a Rutgeerts score of ≥ i2. The following variables were investigated as potential risk factors for EPER: gender, age at surgery, location and behaviour of CD, smoking, concomitant perianal lesions, preoperative use of steroids, immunomodulators and biologics, previous resection, blood transfusion, surgical procedure (open vs laparoscopic approach), length of resected bowel, type of anastomosis (side-to-side vs end-to-end), postoperative complications, granuloma and postoperative biological therapy. Variables related to the patient, disease and surgical procedure were investigated as potential risk factors for EPER, with univariate and multivariate (logistic regression) analyses. Results: 43/127 (34%) patients had EPER at the time of the first postoperative ileocolonoscopy. In univariate analysis, only preoperative steroid use was significantly associated with a higher rate of EPER [21/45 patients (47%) on steroids and 22/82 patients (27%) without steroids (P = 0.04)]. In multivariate analysis, only preoperative steroid use was a significant independent risk factor for EPER (odds ratio 3.28, 95% confidence interval: 1.30–8.28; P = 0.01). Conclusions: This study found that only preoperative steroid use was a significant risk factor for EPER after ileocolonic resection for CD. Prospective studies are necessary to evaluate precisely the impact of perioperative medications on EPER rates.en
dc.description.affiliationColorectal Surgery Unit Cajuru University Hospital Catholic University of Paraná
dc.description.affiliationColorectal Surgery Unit Humanitas Research Hospital
dc.description.affiliationGastroenterology Unit Toho University Sakura Medical Centre
dc.description.affiliationGastrosaude Outpatient Clinic
dc.description.affiliationIBD Unit Heliopolis Hospital
dc.description.affiliationDigestive Surgery Department Sao Paulo State University (UNESP)
dc.description.affiliationIBD Centre Yokkaichi Hazu Medical Centre
dc.description.affiliationUnespDigestive Surgery Department Sao Paulo State University (UNESP)
dc.format.extentO39-O45
dc.identifierhttp://dx.doi.org/10.1111/codi.13581
dc.identifier.citationColorectal Disease, v. 19, n. 1, p. O39-O45, 2017.
dc.identifier.doi10.1111/codi.13581
dc.identifier.issn1463-1318
dc.identifier.issn1462-8910
dc.identifier.scopus2-s2.0-85008319356
dc.identifier.urihttp://hdl.handle.net/11449/178550
dc.language.isoeng
dc.relation.ispartofColorectal Disease
dc.relation.ispartofsjr1,229
dc.relation.ispartofsjr1,229
dc.rights.accessRightsAcesso restrito
dc.sourceScopus
dc.subjectCrohn's disease
dc.subjectendoscopic recurrence
dc.subjectileocolonic resection
dc.subjectpostoperative recurrence
dc.subjectrisk factor
dc.titleFactors affecting the incidence of early endoscopic recurrence after ileocolonic resection for Crohn's disease: a multicentre observational studyen
dc.typeArtigo

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