Year 2015 / Volume 107 / Number 10
Original
Impact of endoscopic monitoring in postoperative Crohn’s disease patients already receiving pharmacological prevention of recurrence

586-590

DOI: 10.17235/reed.2015.3836/2015

Yago González-Lama, Isabel Blázquez, Cristina J. Suárez, Borja Oliva, Virginia Matallana, Marta Calvo, Isabel Vera, Luis Abreu,

Abstract
Background: Current guidelines address the initiation of treatment to prevent postoperative recurrence (PR) after ileo-cecal resection in Crohn’s disease (CD), but appropriate management of postoperative CD patients who are already receiving treatment to prevent PR is yet to be defined. Usefulness of endoscopic monitoring in this scenario remains uncertain. Aims: To evaluate the usefulness of endoscopy-based management of postoperative CD patients who are already under pharmacological prevention of PR. Methods: Retrospective review of clinical outcome of all CD patients with ileo-cecal resection who underwent postoperative colonoscopy between 2004 and 2013 at our centre. Postoperative endoscopic findings were classified as no endoscopic recurrence (Rutgeerts i0-i1) or endoscopic recurrence (Rutgeerts i2-i4). Patients with endoscopic recurrence were classified as “endoscopy-based management (EBM)” if treatment step-up after endoscopy, or “non EBM (N-EBM)”. Clinical recurrence was considered if re-operation, CD related hospitalization or treatment change. Time until clinical recurrence or the end of the follow up was considered. Results: One hundred sixty six patients initially identified. One hundred twenty nine (77%) under pharmacological prevention of PR at the time of colonoscopy were analyzed: 34% were receiving aminosalicylates, 50% thiopurines, 11% anti-TNF, 5% combo. Colonoscopy showed endoscopic recurrence in 57% of patients; those with N-EBM were more likely to have clinical recurrence than patients with EBM along the follow up (p = 0.01). Conclussions: Endoscopic monitoring could be useful in postoperative CD patients also in patients already receiving pharmacological treatment to prevent PR.
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References
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González-Lama Y, Blázquez I, Suárez C, Oliva B, Matallana V, Calvo M, et all. Impact of endoscopic monitoring in postoperative Crohn’s disease patients already receiving pharmacological prevention of recurrence. 3836/2015


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Publication history

Received: 06/05/2015

Accepted: 01/07/2015

Online First: 14/07/2015

Published: 25/09/2015

Article revision time: 54 days

Article Online First time: 69 days

Article editing time: 142 days


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