Background: The identification of patients prone to early recurrence of Crohn's disease at the site of a strictureplasty is fundamental in the clinical practice. Aims: Aim of the study is to detect the risk factors for early reoperation for recurrence after primary strictureplasty. Methods: From 2000, patients undergoing a primary strictureplasty and a subsequent reoperation for recurrence of Crohn's disease at the site of a strictureplasty were included. Univariate and multivariable linear regression models were performed to analyse the relationship between the time to recurrence and independent variables. Results: Fifty-nine patients were included. Median time to recurrence was 4.5 years (0.7–12.6). At the multivariate linear regression, early relapse was significantly associated with use of biologics before primary surgery (−2.69, p < 0.0001) and location of disease in the ileum (−1.61, p 0.017). The use of biologics after surgery was similar between groups (40.7 vs 37.5%, p 0.79). Conclusions: The location of Crohn's disease in the ileum and the use of biologics before surgery are strong predictors of early site-specific recurrence after strictureplasty. In this group of patients, a tailored follow-up and aggressive postoperative treatment should be considered.
Rottoli, M., Vallicelli, C., Ghignone, F., Tanzanu, M., Vitali, G., Gionchetti, P., et al. (2019). Predictors of early recurrence after strictureplasty for Crohn's disease of the small bowel during the years of biologics. DIGESTIVE AND LIVER DISEASE, 51(5), 663-668 [10.1016/j.dld.2018.11.027].
Predictors of early recurrence after strictureplasty for Crohn's disease of the small bowel during the years of biologics
Rottoli, Matteo
;Vallicelli, Carlo;Ghignone, Federico;Tanzanu, Marta;Vitali, Giulia;Gionchetti, Paolo;Rizzello, Fernando;Poggioli, Gilberto
2019
Abstract
Background: The identification of patients prone to early recurrence of Crohn's disease at the site of a strictureplasty is fundamental in the clinical practice. Aims: Aim of the study is to detect the risk factors for early reoperation for recurrence after primary strictureplasty. Methods: From 2000, patients undergoing a primary strictureplasty and a subsequent reoperation for recurrence of Crohn's disease at the site of a strictureplasty were included. Univariate and multivariable linear regression models were performed to analyse the relationship between the time to recurrence and independent variables. Results: Fifty-nine patients were included. Median time to recurrence was 4.5 years (0.7–12.6). At the multivariate linear regression, early relapse was significantly associated with use of biologics before primary surgery (−2.69, p < 0.0001) and location of disease in the ileum (−1.61, p 0.017). The use of biologics after surgery was similar between groups (40.7 vs 37.5%, p 0.79). Conclusions: The location of Crohn's disease in the ileum and the use of biologics before surgery are strong predictors of early site-specific recurrence after strictureplasty. In this group of patients, a tailored follow-up and aggressive postoperative treatment should be considered.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.