Long term remission after ileorectal anastomosis in Crohn's colitis
| Autor: | D. Sgambato, Silvio Laureti, Fernando Rizzello, Gilberto Poggioli, Paolo Gionchetti, Marco Salice, Matteo Rottoli, Francesco Manguso, Carlo Calabrese |
|---|---|
| Přispěvatelé: | Salice M., Rizzello F., Sgambato D., Calabrese C., Manguso F., Laureti S., Rottoli M., Poggioli G., Gionchetti P. |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Crohn's colitis IBD Disease Gastroenterology 03 medical and health sciences 0302 clinical medicine Crohn Disease Ileorectal anastomosis Refractory Recurrence Internal medicine medicine Humans Colitis Colectomy Retrospective Studies Crohn's disease Hepatology Ileostomy business.industry Anastomosis Surgical Middle Aged medicine.disease digestive system diseases Clinical trial Ileorectal anastomosi 030220 oncology & carcinogenesis Female Surgery 030211 gastroenterology & hepatology business |
| Zdroj: | Digestive and Liver Disease. 53:592-597 |
| ISSN: | 1590-8658 |
| Popis: | Background: Crohn's disease represents a heterogeneous entity, but its location tends to be relatively stable overtime. For extensive refractory Crohn's colitis, ileorectal anastomosis after colectomy is an engaging option, since the necessity of a permanent ileostomy is avoided. Aims: In our study, the long-term outcome of two groups of patients with Crohn's colitis who underwent colectomy and ileorectal anastomosis was compared. The first group had isolated colonic Crohn's disease without rectal involvement and perianal disease, while the second group included patients who had rectal and/or ileal involvement, with or without perianal disease. Methods: Between 1996 and 2016, in a single IBD tertiary center, 80 patients with a history of colectomy and ileorectal anastomosis for refractory Crohn's colitis were retrospectively identified. Results: Recurrence of disease was diagnosed in 57/64 of patients with Crohn's colitis with rectal and/or ileal and/or perianal involvement compared with 1/16 of patients with isolated Crohn's colitis without rectal and perianal disease in a median time of recurrence of 2 years (IQR 1–6 years, minimum to maximum, 1–18 years, p < 0.001). Only 6 patients (7,5%) underwent definitive end ileostomy without proctectomy (1 in the noIRP group and 5 in the IRP group). Conclusion: Our data suggest that colectomy with ileorectal anastomosis may represent a curative option in patients with refractory isolated colitis without rectal and perianal involvement. |
| Databáze: | OpenAIRE |
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