RT Journal Article
T1 Incidence and Management of Recurrence in Patients with Crohn's Disease Who Have Undergone Intestinal Resection: The Practicrohn Study.
A1 Domenech, Eugeni
A1 Garcia, Valle
A1 Iborra, Marisa
A1 Gutierrez, Ana
A1 Garcia-Lopez, Santiago
A1 Martin Arranz, Maria D
A1 Garcia-Planella, Esther
A1 Calvo, Marta
A1 Castro, Luisa
A1 Minguez, Miguel
A1 Taxonera, Carlos
A1 Julia, Berta
A1 Cea-Calvo, Luis
A1 Romero, Cristina
A1 Barreiro-de Acosta, Manuel
K1 Adult
K1 Colectomy
K1 Crohn disease
K1 Endoscopy
K1 Follow-up studies
AB More than 50% of patients with Crohn's disease require intestinal resection at least once. Postoperative recurrence (POR) is almost uniform if prophylactic treatment is not started early. Endoscopic monitoring is generally advised. We studied the incidence and management of recurrence in patients who had undergone intestinal resection. Practicrohn was an observational retrospective study performed in 26 Spanish hospitals including patients aged ≥18 years who underwent Crohn's disease-related ileocolonic resection between January 2007 and December 2010. We recorded preventive treatments, the incidence of clinical recurrence in daily practice, and associated risk factors. The study population comprised 314 patients. Median (interquartile range) time from diagnosis to surgery was 6 (1-12) years. Prophylaxis for POR was administered to 208 patients (68%). Endoscopy was performed in 143 (46%) patients the first year after surgery. Clinical POR was detected in 97 patients (31%) after a median 315 (65-748) days. The cumulative probability of clinical POR was 16%, 27%, and 31% at 1, 3, and 5 years, respectively, being higher among patients not receiving immunomodulators as compared to those who received prophylaxis (P = 0.014). Forty-five patients (14%) required reoperation at 5 years after a median time from the first intervention of 228 (133-527) days. In this real-life study, up to one-third of patients with Crohn's disease did not start preventive therapy after intestinal resection, and almost half of them were not endoscopically monitored as recommended. In this setting, 30% of patients developed clinical POR within the first 5 years after surgery, thus indicating that there is room for improvement.
PB Oxford University Press
YR 2017
FD 2017-04-25
LK http://hdl.handle.net/10668/11336
UL http://hdl.handle.net/10668/11336
LA en
NO Domènech E, Garcia V, Iborra M, Gutiérrez A, García-López S, Martín Arranz MD, et al. Incidence and Management of Recurrence in Patients with Crohn's Disease Who Have Undergone Intestinal Resection: The Practicrohn Study. Inflamm Bowel Dis. 2017 Oct;23(10):1840-1846
DS RISalud
RD Apr 9, 2025