| International Session（Symposium）7(JSGS・JSGE・JGES) |
| Sat. November 23rd 10:00 - 12:00 Room 1: Kobe International Exhibition Hall No.2 Building Hall (North) |
| The impact of early endoscopic lesions on the clinical course of patients after ileocolonic resection for Crohn's disease: a 5-year prospective cohort study | |||
| Takayuki Yamamoto1, Takahiro Shimoyama1, Satoru Umegae1 | |||
| 1Yokkaichi Hazu Medical Center | |||
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| Aim: This prospective study was to investigate the impact of early endoscopic lesions on future clinical recurrence after ileocolonic resection for Crohn's disease (CD). Methods: Forty patients who had maintained clinical remission (CD activity index [CDAI]<150) with mesalazine during 6 months after ileocolonic resection for CD were included. At 6 months after surgery, ileocolonoscopy was performed, and the endoscopic activity score at the proximal site of the anastomosis was determined according to Rutgeerts. All patients were regularly monitored for 5 years, and clinical recurrence was defined as CDAI≥150. Corticosteroids, immunosuppressants or biologic agents were not given unless there was clinical recurrence. Results: At 6 months after surgery, the endoscopic scores were i0 or i1 in 27 patients, i2 in 7, i3 in 4, and i4 in 2. During the following 5 years, the clinical recurrence occurred in 3 (11%) of the 27 patients with endoscopic score of i0 or i1, 4 (57%) of the 7 patients with i2, 3 (75%) of the 4 patients with i3, and 2 (100%) of the 2 patients with i4, showing a significant positive correlation (P=0.001) between the endoscopic severity and the clinical recurrence rate. Conclusions: The assessment of endoscopic lesions at the proximal site of the anastomosis appeared to be valuable for predicting subsequent clinical recurrence after ileocolonic resection for CD. |
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Index Term 1: Crohn's disease Index Term 2: Postoperative recurrence |
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