Impact of capsule endoscopy on prevention of postoperative recurrence of Crohn's disease
| Autor: | Xicheng Feng, Zhenyu Chen, Aimin Li, Side Liu, Jie Zhang, Ze-min Han, Zhi-Min Xu, Tianmo Wan, Xiuyun Ai, Weiguang Qiao, Mingsong Li, Yang Bai, Fachao Zhi |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Colonoscopy Gastroenterology Asymptomatic Capsule Endoscopy law.invention Cohort Studies 03 medical and health sciences 0302 clinical medicine Crohn Disease Capsule endoscopy law Ileum Recurrence Internal medicine Azathioprine medicine Secondary Prevention Humans Radiology Nuclear Medicine and imaging Endoscopy Digestive System Postoperative Period Colectomy Retrospective Studies Crohn's disease medicine.diagnostic_test business.industry Disease Management Retrospective cohort study Middle Aged medicine.disease Crohn's Disease Activity Index Infliximab 030220 oncology & carcinogenesis Antirheumatic Agents Asymptomatic Diseases 030211 gastroenterology & hepatology Female medicine.symptom business medicine.drug |
| Zdroj: | Gastrointestinal endoscopy. 87(6) |
| ISSN: | 1097-6779 |
| Popis: | Background and Aims Capsule endoscopy (CE) can detect lesions outside the scope of ileocolonoscopy in postoperative patients with Crohn's disease (CD). However, the impact of such findings on patient outcomes remains unknown. This study is intended to evaluate the impact of CE findings on clinical management and outcomes in asymptomatic patients with CD without pharmacologic prophylaxis after ileocolonic resection. Methods In this retrospective cohort study, 37 patients (group 1) received ileocolonoscopy together with CE within 1 year after surgery, whereas 46 patients (group 2) only received ileocolonoscopy. Patients with endoscopic recurrence detected by either ileocolonoscopy or CE received pharmacologic therapy with azathioprine or infliximab. One year later, disease activity was re-evaluated. Results In group 1, all patients with ileocolonoscopy-identified recurrence also had CE-identified recurrence. In addition, CE detected endoscopic recurrence in 11 patients missed by ileocolonoscopy. Endoscopic remission identified by ileocolonoscopy was confirmed by CE in 13 patients. One year later, endoscopic remission identified by ileocolonoscopy was maintained in all 24 patients, and none had clinical recurrence. Conversely, in group 2, of those with ileocolonoscopy-identified remission, both ileocolonoscopy-identified recurrence and clinical recurrence occurred in 9 of 31 patients 1 year later. The total clinical recurrence rate was 2.7% (1/37) in group 1 versus 21.7% (10/46) in group 2 ( P = .019). Conclusions If endoscopic remission identified by ileocolonoscopy was confirmed by CE, patients could remain free of pharmacologic prophylaxis. If recurrence outside the scope of ileocolonoscopy was detected by CE, initiation of active pharmacologic therapy would be needed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect