| International Session（Symposium）2(JSGE・JGES) |
| Thu. November 21st 14:00 - 16:30 Room 2: Portopia Hotel South Wing Topaz |
| Treatment to targets of total mural healing assessed by endoscopy and MR-DWI avoids surgery in newly diagnosed Crohn’ s disease | |||
| Hirotake Sakuraba1, Hiroto Hiraga1, Shinsaku Fukuda1 | |||
| 1Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine | |||
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| The therapeutic goal of Crohn's disease (CD) is prevention of the irreversible intestinal damage. We investigated whether the strategy of therapy according to the poor prognostic factors and achieving total mural and perianal healing by endoscopy and magnetic resonance diffusion-weighted imaging (MR-DWI) could lead better outcomes or not. Total 53 newly diagnosed CD patients were enrolled with a mean follow-up of 4.0 years. Initial treatments were selected according to three poor prognostic factors (extensive small bowel lesion, B2 or B3 behavior, perianal lesion). First assessments of disease activity were performed at 6-12 months after the initial treatment. Therapeutic targets were defined as ileocolonoscopic and capsule endoscopic remission with low signal intensity of intestinal wall by MR-DWI including perianal lesion. Therapeutic targets were achieved in 38 patients and not in 15 patients at first assessment. 5 patients were needed surgical treatments and 10 patients required to optimize ongoing treatment. 13 of them achieved the target at second assessment. Patients who achieved the targets both first and second assessments showed better outcomes at third assessment. Patients achieving the therapeutic targets were to avoid surgery during the follow-up. Achieving mucosal, mural and perianal healing according to endoscopy and MR-DWI was therapeutic target which lead to favorable outcomes in patients with CD. |
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Index Term 1: T2T Index Term 2: mural healing |
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