scholarly journals Previous Intestinal Resection Is Associated with Postoperative Complications in Crohn’s Disease: A Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Yantao Duan ◽  
Yifan Liu ◽  
Yousheng Li
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Intestinal Resection ◽  
Postoperative Mortality ◽  
Aminosalicylic Acid ◽  
Cross Sectional ◽  
Physical Status Classification ◽  
Estimated Blood Loss ◽  
Surgical Data

Background. To assess the influence of a previous intestinal resection on postoperative complications for Crohn’s disease (CD). Methods. Data on patients with CD undergoing surgery in our department from January 2016 through December 2019 were retrospectively reviewed. Information collected included demographic details, surgical data, and postoperative outcome. A cross-sectional study design was employed. Associations between postoperative complications and preoperative clinical indicators were further analyzed. Results. Of the 129 patients with CD studied, 62 patients (48.06%) underwent previous resection. These patients were more likely to be older (P=0.031), have longer disease duration (P=0.025), use less 5-aminosalicylic acid/sulfasalazine preoperatively (P=0.013), have lower body mass index (P=0.003), and have a higher American Society of Anesthesiologists (ASA) Physical Status Classification System score (P=0.043). Patients who had previous surgery had a longer duration of operation (P=0.003), greater estimated blood loss (P=0.001), and longer hospital stay (P<0.001) and were more inclined to develop postoperative complications (P=0.047), particularly anastomotic leak (P=0.021) and severe (Clavien–Dindo grade III/IV) complications (P=0.038). After multivariate analysis, previous intestinal resection (P=0.019), preoperative use of steroids (P=0.026), and ASA score of more than II (P<0.001) were determined to be the independent prognostic risk factors for postoperative complications. During the 30-day follow-up period, there was no postoperative mortality or readmission. Conclusions. Previous intestinal resection in patients with CD is an independent predictor of overall postoperative complications.

scholarly journals P598 Previous Intestinal Resection Is Associated with Postoperative Complications in Crohn’s Disease: A Cohort Study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S545-S545
Author(s):  
Y Li ◽  
Y Duan ◽  
Z Zhiyuan ◽  
Y Danhua
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Intestinal Resection ◽  
Postoperative Mortality ◽  
Aminosalicylic Acid ◽  
Cross Sectional ◽  
Physical Status Classification ◽  
Estimated Blood Loss ◽  
Surgical Data

Abstract Background To assess the influence of a previous intestinal resection on postoperative complications for Crohn’s disease (CD). Methods Data on patients with CD undergoing surgery in our department from January 2016 through December 2019 were retrospectively reviewed. Information collected included demographic details, surgical data, and postoperative outcome. A cross- sectional study design was employed. Associations between postoperative complications and preoperative clinical indicators were further analyzed. Results Of the 129 patients with CD studied, 62 patients (48.06%) underwent previous resection. These patients were more likely to be older (P=0:031), have longer disease duration (P=0:025), use less 5-aminosalicylic acid/sulfasalazine preoperatively (P = 0:013), have lower body mass index (P = 0:003), and have a higher American Society of Anesthesiologists (ASA) Physical Status Classification System score (P = 0:043). Patients who had previous surgery had a longer duration of operation (P = 0:003), greater estimated blood loss (P = 0:001), and longer hospital stay (P &lt; 0:001) and were more inclined to develop postoperative complications (P=0:047), particularly anastomotic leak (P=0:021) and severe (Clavien– Dindo grade III/IV) complications (P = 0:038). After multivariate analysis, previous intestinal resection (P = 0:019), preoperative use of steroids (P = 0:026), and ASA score of more than II (P &lt; 0:001) were determined to be the independent prognostic risk factors for postoperative complications. During the 30-day follow-up period, there was no postoperative mortality or readmission. Conclusion Previous intestinal resection in patients with CD is an independent predictor of overall postoperative complications.

Determinants for postoperative complications after laparoscopic intestinal resection for Crohn’s disease

2011 ◽  
Vol 26 (4) ◽  
pp. 933-938 ◽  
Author(s):  
Stefan Riss ◽  
Clemens Bittermann ◽  
Katrin Schwameis ◽  
Ivan Kristo ◽  
Martina Mittlböck ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Intestinal Resection

scholarly journals 5-Aminosalicylic Acid Prevents Disease Behavior Progression and Intestinal Resection in Colonic and Ileocolonic Crohn’s Disease Patients: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jian Wan ◽  
Xuan Wang ◽  
Yujie Zhang ◽  
Xianmin Xue ◽  
Yani Li ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Cox Regression ◽  
Intestinal Resection ◽  
Aminosalicylic Acid ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Disease Behavior ◽  
Disease Location

Background and Aims. The efficacy of 5-aminosalicylic acid (5-ASA) in the long-term outcome of Crohn’s disease (CD) patients was uncertain. This study aimed to evaluate the efficacy of the 5-ASA in preventing disease behavior progression and intestinal resection in CD patients. Methods. CD patients were prospectively enrolled from January 2008 to September 2019 in Xijing Hospital. Disease behavior progression was defined as the development of stricturing (B2) or penetrating disease (B3) in patients with nonstricturing/nonpenetrating disease (B1) at diagnosis. Cox regression analyses were used to investigate the associations between disease location progression, disease behavior progression, and intestinal resection and multiple covariates. Results. In total, 122 CD patients were followed up for 4.3 years. At the time of diagnosis, disease location was ileal in 19.7% (24/122), colonic in 41.0% (50/122), and ileocolonic in 39.3% (48/122). A total of 87 (71.3%) patients had B1 at diagnosis. The disease behavior progression and intestinal resection rates were 42.5% (37/87) and 29.5% (36/122). The use of 5-ASA reduced the risk of disease behavior progression (HR 0.30, 95% CI 0.14–0.61, P  = 0.001) and intestinal resection (HR 0.33, 95% CI 0.17–0.90, P  = 0.027) in colonic and ileocolonic CD patients. Patients who presented with ileal disease at diagnosis did not have the same protective effects when taking 5-ASA ( P  > 0.05). Conclusions. The use of 5-ASA could improve the long-term outcome of CD patients with colon involvement. The result emphasized the importance of early use of 5-ASA in the daily management of colonic involved CD.

scholarly journals Endoscopic and Histopathological Findings of the Esophagus, Stomach, and Duodenum in Patients with Crohn’s Disease from a Reference Center in Bahia, Brazil

2021 ◽  
Vol 11 (2) ◽  
pp. 374-385
Author(s):  
Andrea Maia Pimentel ◽  
Luiz Antônio Rodrigues de Freitas ◽  
Rita de Cássia Reis Cruz ◽  
Isaac Neri de Novais Silva ◽  
Laíla Damasceno Andrade ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Mononuclear Cells ◽  
Erosive Esophagitis ◽  
Gastric Body ◽  
Polymorphonuclear Cells ◽  
Cross Sectional ◽  
Histopathological Findings ◽  
Focally Enhanced Gastritis ◽  
H Pylori

(1) The aim of the present study was to describe the endoscopic and histopathological findings in the esophagus, stomach, and duodenum in patients with Crohn’s disease. (2) Methods: This was a cross-sectional study that included patients receiving treatment from the inflammatory bowel disease outpatient clinic. Esophagogastroduodenoscopies with biopsies of the stomach and proximal duodenum were performed. Presence of Helicobacter pylori bacteria was assessed by Giemsa staining. (3) Results: We included 58 patients. Erosive esophagitis was identified in 25 patients (43.1%), gastritis was diagnosed in 32 patients (55.2%) and erosive duodenitis was found in eight (13.8%). The most frequent histopathological finding in the H. pylori-positive group was increased inflammatory activity in the gastric body and antrum, with a predominance of mononuclear and polymorphonuclear cells. In turn, the most frequent finding in the H. pylori-negative group was chronic inflammation with predominance of mononuclear cells. Focally enhanced gastritis was identified in four patients (6.9%), all of whom were negative for H. pylori. Granulomas were not observed. H. pylori infection was present in 19 patients (32.8%). (4) Conclusions: Nonspecific endoscopic and histological findings were frequent in patients with Crohn’s disease. Focally enhanced gastritis was uncommon and observed only in H. pylori-negative patients. The time from the diagnosis, patient age, and therapy in use may have influenced the nondetection of epithelioid granuloma.

scholarly journals Relevance of monitoring transmural disease activity in patients with Crohn’s disease: current status and future perspectives

2021 ◽  
Vol 14 ◽  
pp. 175628482110066
Author(s):  
Rune Wilkens ◽  
Kerri L. Novak ◽  
Christian Maaser ◽  
Remo Panaccione ◽  
Torsten Kucharzik
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Symptom Control ◽  
Current Status ◽  
Clinical Relapse ◽  
Cross Sectional ◽  
Treatment Targets ◽  
Endoscopic Remission ◽  
Transmural Inflammation

Treatment targets of inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn’s disease (CD) have evolved over the last decade. Goals of therapy consisting of symptom control and steroid sparing have shifted to control of disease activity with endoscopic remission being an important endpoint. Unfortunately, this requires ileocolonoscopy, an invasive procedure. Biomarkers [C-reactive protein (CRP) and fecal calprotectin (FCP)] have emerged as surrogates for endoscopic remission and disease activity, but also have limitations. Despite this evolution, we must not lose sight that CD involves transmural inflammation, not fully appreciated with ileocolonoscopy. Therefore, transmural assessment of disease activity by cross-sectional imaging, in particular with magnetic resonance enterography (MRE) and intestinal ultrasonography (IUS), is vital to fully understand disease control. Bowel-wall thickness (BWT) is the cornerstone in assessment of transmural inflammation and BWT normalization, with or without bloodflow normalization, the key element demonstrating resolution of transmural inflammation, namely transmural healing (TH) or transmural remission (TR). In small studies, achievement of TR has been associated with improved long-term clinical outcomes, including reduced hospitalization, surgery, escalation of treatment, and a decrease in clinical relapse over endoscopic remission alone. This review will focus on the existing literature investigating the concept of TR or residual transmural disease and its relation to other existing treatment targets. Current data suggest that TR may be the next logical step in the evolution of treatment targets.

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