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BIBTEX RIS

Short and long-term outcomes of surgery for inflammatory (uncomplicated) ileocecal Crohn's disease: Multicentric retrospective analysis of 211 patients

2023; Elsevier BV; Volume: 56; Issue: 5 Linguagem: Inglês

10.1016/j.dld.2023.10.017

1878-3562

Nicolás Avellaneda, Annalisa Maroli, Anders P. Tøttrup, Christianne J. Buskens, Paulo Gustavo Kotze, Gianluca Pellino, Anders Dige, Anne‐Mette Haase, Anouck Haanappel, Lorenzo Giorgi, Michele Carvello, Beatriz Yuki Maruyama, Peter Christensen, Antonino Spinelli,

Microscopic Colitis

Abstract Background Surgical management for patients with inflammatory ileocecal Crohn's disease (CD) could be a reasonable alternative to second-line medical treatment. Aim To assess short and long-term outcomes of patients operated on for inflammatory, ileocecal Crohn's disease. Methods A retrospective analysis of patients intervened at four referral hospitals during 2012–2021 was performed. Results 211 patients were included. 43% of patients underwent surgery more than 5 years after diagnosis, and 49% had been exposed to at least one biologic agent preoperatively. 89% were operated by laparoscopy, with 1.6% conversion rate. The median length of the resected bowel was 25 cm (7–92) and three patients (1.43%) received a stoma. Median follow-up was 36 (17–70) months. The endoscopic recurrence-free survival proportion at 24, 48, 72, 96, and 120 months was 56%, 52%, 45%, 38%, and 33%, respectively. The clinical recurrence-free survival proportion at 24, 48, 72, 96, and 120 months was 83%, 79%, 76%, 74%, and 74%, respectively. In multivariate analysis, previous biological treatment (HR=2.01; p = 0.001) was associated with a higher risk of overall recurrence. Conclusion Surgery in patients with primary inflammatory ileocecal CD is associated with good postoperative outcomes, low postoperative morbidity with reasonable recurrence rates.