Risk and significance of endoscopic/radiological evidence of recurrent Crohn's disease.
| Autor: | McLeod RS; Department of Surgery, University of Toronto, Ontario, Canada., Wolff BG, Steinhart AH, Carryer PW, O'Rourke K, Andrews DF, Blair JE, Cangemi JR, Cohen Z, Cullen JB, Chaytor RG, Greenberg GR, Jaffer NM, Jeejeebhoy KN, MacCarty RL, Ready RL, Weiland LH |
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| Jazyk: | angličtina |
| Zdroj: | Gastroenterology [Gastroenterology] 1997 Dec; Vol. 113 (6), pp. 1823-7. |
| DOI: | 10.1016/s0016-5085(97)70001-5 |
| Abstrakt: | Background & Aims: The aim of this study was to determine the risk of endoscopic/radiological recurrence of Crohn's disease postoperatively and the long-term outcome. Methods: A randomized placebo-controlled trial was performed to determine the effectiveness of mesalamine in preventing recurrent Crohn's disease postoperatively. Patients in the control group were examined endoscopically/radiologically before entry into and annually during the trial. Findings were classified as minimal or severe. Results: There were 76 patients (49 men and 37 women; mean age, 37.1 +/- 13.2 years). Fifty (61.7%) had terminal ileal resections. Overall, 55 endoscopic/radiological recurrences were observed in 51 patients (67.1%). Expressed actuarially, the recurrence rate was 27.5% at 1 year (95% confidence interval [CI], 15.8%-37.6%), 60.8% at 2 years (95% CI, 46%-71.3%), and 77.3% at 3 years (95% CI, 62.7%-86.3%). Nineteen (37%) were symptomatic and 12 (24%) were initially asymptomatic but later became symptomatic (mean, 13.0 +/- 8.8 months), whereas 20 (39%) remained asymptomatic (mean, 16.9 +/- 17.4 months). Patients with severe endoscopic/radiological disease were significantly more likely to be or become symptomatic than those with minimal disease (23 of 32 vs. 8 of 19, respectively; P = 0.0437). Conclusions: This study suggests that postoperative endoscopic/radiological recurrences occur later than previously reported. Furthermore, many of these patients, especially with minimal disease, will remain asymptomatic. |
| Databáze: | MEDLINE |
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