TY - JOUR
T1 - Short and long-term outcomes of surgery for inflammatory (uncomplicated) ileocecal Crohn's disease
T2 - Multicentric retrospective analysis of 211 patients
AU - Avellaneda, Nicolas
AU - Maroli, Annalisa
AU - Tottrup, Anders
AU - Buskens, Christianne
AU - Kotze, Paulo Gustavo
AU - Pellino, Gianluca
AU - Dige, Anders
AU - Haase, Anne-Mette
AU - Haanappel, Anouck
AU - Giorgi, Lorenzo
AU - Carvello, Michelle
AU - Maruyama, Beatriz Yuki
AU - Christensen, Peter
AU - Spinelli, Antonino
N1 - Funding Information: N.A. participated in study planning, design, protocol writing, invitation to centers, recruitment control, manuscript writing, manuscript submission. A.M. participated in protocol design and manuscript statistical analysis. A.T. G.P. A.S. participated in study planning, design, protocol writing, manuscript edition. C.B. A.H. A.D. A.M.H. L.G. B.Y.M. participated in recruitment of patients in their centers and in the manuscript edition and correction. P.G.K. and M.C. participated in recruitment of patients in their center and in the manuscript edition and correction. P.C. participated in the process to get legal approval for the study, and in manuscript edition and correction., This study was not funded. Publisher Copyright: © 2023
PY - 2023
Y1 - 2023
N2 - Background: Surgical management for patients with inflammatory ileocecal Crohn's disease (CD) could be a reasonable alternative to second-line medical treatment. Aim: To assess short and long-term outcomes of patients operated on for inflammatory, ileocecal Crohn's disease. Methods: A retrospective analysis of patients intervened at four referral hospitals during 2012–2021 was performed. Results: 211 patients were included. 43% of patients underwent surgery more than 5 years after diagnosis, and 49% had been exposed to at least one biologic agent preoperatively. 89% were operated by laparoscopy, with 1.6% conversion rate. The median length of the resected bowel was 25 cm (7–92) and three patients (1.43%) received a stoma. Median follow-up was 36 (17–70) months. The endoscopic recurrence-free survival proportion at 24, 48, 72, 96, and 120 months was 56%, 52%, 45%, 38%, and 33%, respectively. The clinical recurrence-free survival proportion at 24, 48, 72, 96, and 120 months was 83%, 79%, 76%, 74%, and 74%, respectively. In multivariate analysis, previous biological treatment (HR=2.01; p = 0.001) was associated with a higher risk of overall recurrence. Conclusion: Surgery in patients with primary inflammatory ileocecal CD is associated with good postoperative outcomes, low postoperative morbidity with reasonable recurrence rates.
AB - Background: Surgical management for patients with inflammatory ileocecal Crohn's disease (CD) could be a reasonable alternative to second-line medical treatment. Aim: To assess short and long-term outcomes of patients operated on for inflammatory, ileocecal Crohn's disease. Methods: A retrospective analysis of patients intervened at four referral hospitals during 2012–2021 was performed. Results: 211 patients were included. 43% of patients underwent surgery more than 5 years after diagnosis, and 49% had been exposed to at least one biologic agent preoperatively. 89% were operated by laparoscopy, with 1.6% conversion rate. The median length of the resected bowel was 25 cm (7–92) and three patients (1.43%) received a stoma. Median follow-up was 36 (17–70) months. The endoscopic recurrence-free survival proportion at 24, 48, 72, 96, and 120 months was 56%, 52%, 45%, 38%, and 33%, respectively. The clinical recurrence-free survival proportion at 24, 48, 72, 96, and 120 months was 83%, 79%, 76%, 74%, and 74%, respectively. In multivariate analysis, previous biological treatment (HR=2.01; p = 0.001) was associated with a higher risk of overall recurrence. Conclusion: Surgery in patients with primary inflammatory ileocecal CD is associated with good postoperative outcomes, low postoperative morbidity with reasonable recurrence rates.
KW - Colectomy
KW - Crohn's disease
KW - Postoperative complications
KW - Recurrence
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=85179070547&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.dld.2023.10.017
DO - https://doi.org/10.1016/j.dld.2023.10.017
M3 - Article
C2 - 38044224
SN - 1590-8658
JO - Digestive and liver disease
JF - Digestive and liver disease
ER -