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International Journal of Colorectal Disease

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01-09-2007 | Original Article

Surgical predictors of recurrence of Crohn’s disease after ileocolonic resection

Authors: Marco Scarpa, Cesare Ruffolo, Eugenia Bertin, Lino Polese, Teresa Filosa, Daniela Prando, Duilio Pagano, Lorenzo Norberto, Mauro Frego, Davide F. D’Amico, Imerio Angriman

Published in: International Journal of Colorectal Disease | Issue 9/2007

Abstract

Background/aims

Anastomotic recurrence after bowel resection is a major problem in Crohn’s disease (CD) surgery. The aims of this retrospective study are to assess the role of anastomotic configuration, the type of suture and the type of surgical approach (laparoscopy-assisted vs laparotomy) in CD recurrence. Secondary end points were to identify any possible predictor that would help the selection of patients for medical prophylaxis.

Materials and methods

In this retrospective study, we enrolled 141 consecutive patients who had undergone ileocolonic resection for CD. Univariate actuarial analysis was performed according to demographic, clinical and surgical predictors. Variables that resulted to be significant at the univariate analysis were included in two multivariate Cox proportional hazards models that analyzed symptomatic and surgical recurrence, respectively.

Results

In the long-term, handsewn side-to-side anastomosis reported a significantly lower surgical recurrence rate than stapled end-to-side (p < 0.05). At multivariate analysis, anastomosis type, surgical and intestinal complications (p < 0.01) and age at CD onset (p < 0.05) resulted to be significant predictors for re-operation for CD recurrence. Multivariate analysis showed that surgical complication was also a significant predictor of symptomatic recurrence.

Conclusions

Side-to-side anastomosis configuration seems to delay re-operation and can be assumed as the standard configuration in ileocolonic anastomosis in CD. Post-operative complications and young age at disease onset might be a signal of aggressive CD that may warrant prophylactic pharmacological therapy.

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Title: Surgical predictors of recurrence of Crohn’s disease after ileocolonic resection
Authors: Marco Scarpa
Cesare Ruffolo
Eugenia Bertin
Lino Polese
Teresa Filosa
Daniela Prando
Duilio Pagano
Lorenzo Norberto
Mauro Frego
Davide F. D’Amico
Imerio Angriman
Publication date: 01-09-2007
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 9/2007
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-007-0329-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Surgical predictors of recurrence of Crohn’s disease after ileocolonic resection

Abstract

Background/aims

Materials and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background/aims

Materials and methods

Results

Conclusions

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