Factors affecting the incidence of early endoscopic recurrence after ileocolonic resection for Crohn's disease: a multicentre observational study
| Autor: | L. M. da Silva Kotze, Antonino Spinelli, Fábio Vieira Teixeira, I. F. de Barcelos, Yasuo Suzuki, Takayuki Yamamoto, Paulo Gustavo Kotze, I. C. de Albuquerque, Rogerio Saad-Hossne |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Colon Anastomosis 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Crohn Disease Ileum Recurrence Risk Factors medicine Humans Risk factor Prospective cohort study Colectomy Retrospective Studies Univariate analysis Crohn's disease business.industry Incidence Gastroenterology Odds ratio Perioperative Colonoscopy medicine.disease Surgery Logistic Models 030220 oncology & carcinogenesis Concomitant Preoperative Period 030211 gastroenterology & hepatology Female Steroids business |
| Zdroj: | Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. 19(1) |
| ISSN: | 1463-1318 |
| Popis: | Aim Early endoscopic recurrence is frequently observed in patients following resection for Crohn's disease (CD). However, factors affecting the incidence of an early postoperative endoscopic recurrence (EPER) have not been fully determined. The aim of this study was to evaluate risk factors for EPER after ileocolonic resections for CD. Method This was a retrospective, international multicentre study, in which 127 patients with the first ileocolonoscopy conducted between 6 and 12 months after ileocolonic resections for CD were included. Endoscopic recurrence was defined as a Rutgeerts’ score of ≥ i2. The following variables were investigated as potential risk factors for EPER: gender, age at surgery, location and behaviour of CD, smoking, concomitant perianal lesions, preoperative use of steroids, immunomodulators and biologics, previous resection, blood transfusion, surgical procedure (open vs. laparoscopic approach), length of resected bowel, type of anastomosis (side-to-side vs. end-to-end), postoperative complications, granuloma, and postoperative biologic therapy. Variables related to the patient, disease and surgical procedure were investigated as potential risk factors for EPER. To identify potential risk factors, both univariate and multivariate (logistic regression) analyses were conducted. Results 43/127 (34%) patients had EPER at the time of the first postoperative ileocolonoscopy. In univariate analysis, only preoperative steroid use was significantly associated with a higher rate of EPER [21/45 patients (47%) on steroids and 22/82 patients (27%) without steroids (P=0.04)]. In multivariate analysis, only preoperative steroid use was a significant independent risk factor for EPER (odds ratio 3.28, 95% confidence interval 1.30 – 8.28; P=0.01). Conclusions This study found that only preoperative steroid use was a significant risk factor for EPER after ileocolonic resections for CD. Prospective studies are necessary to evaluate precisely the impact of perioperative medications on EPER rates. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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