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.

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.
2019
Rottoli, Matteo*; Vallicelli, Carlo; Ghignone, Federico; Tanzanu, Marta; Vitali, Giulia; Gionchetti, Paolo; Rizzello, Fernando; Poggioli, Gilberto
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/656009
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