Ileal or Anastomotic Location of Lesions Does Not Impact Rate of Postoperative Recurrence in Crohn's Disease Patients Classified i2 on the Rutgeerts Score
Ileal or Anastomotic Location of Lesions Does Not Impact Rate of Postoperative Recurrence in Crohn's Disease Patients Classified i2 on the Rutgeerts Score
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DOI：
10.1007/s10620-016-4215-1
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发表时间：
2016-10-01
影响因子：
3.1
通讯作者：
Pariente, B.
中科院分区：
文献类型：
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作者：
Bayart, P.;Duveau, N.;Pariente, B.
具有5个严重程度等级（i 0-i4）的Rutgeorge评分是预测克罗恩病（CD）回结肠切除术后临床复发的合适内镜模型。i2级的定义包括局限于回结肠吻合（i2 a）的病变或新生末端回肠（i2 b）上的中度病变。本研究的目的是评估i2 a和i2 b患者的临床复发概率，这项多中心回顾性研究包括所有在首次术后回结肠镜检查中分类为i2的CD患者。主要结局是评价分类为i2 a和i2 b的患者的临床复发概率。次要结局是比较CD的总体复发率。纳入50例患者：23例分类为i2 a，27例分类为i2 b。i2 a组的中位随访持续时间为40（18.0-80.4）个月，i2 b组为53.5（25.0-69.0）个月（p = 0.9）。分类为i2 a和i2 b的患者之间的临床复发概率无显著差异（p = 0.64）。两组间首次回结肠镜检查后至临床复发的中位时间和CD总体复发概率无差异（p > 0.19）。i2 a和i2 b患者的临床术后复发率无差异。这些结果表明，无论术后CD复发的位置如何，在Rutgeillance评分为i2的所有患者中均应使用相同的治疗策略。
The Rutgeerts score with 5 grades of severity (i0-i4) is a suitable endoscopic model to predict clinical recurrence following ileocolonic resection in Crohn's disease (CD). Definition of grade i2 includes lesions confined to the ileocolonic anastomosis (i2a) or moderate lesions on the neo-terminal ileum (i2b). The aim of the present study was to evaluate the probability of clinical recurrence in i2a and i2b patients.This multicenter retrospective study included all CD patients classified i2 at the first postoperative ileocolonoscopy. The primary outcome was to evaluate the probability of clinical recurrence in patients classified i2a and i2b. The secondary outcome was to compare the rate of global recurrence of CD.Fifty patients were included: 23 were classified i2a and 27 were classified i2b. The median duration of follow-up was 40 (18.0-80.4) months in the i2a group and 53.5 (25.0-69.0) months in the i2b group (p = 0.9). The probability of clinical recurrence was not significantly different between patients classified i2a and i2b (p = 0.64). Median time to clinical recurrence after the first ileocolonoscopy and probability of global CD recurrence were not different between the two groups (p aeyen 0.19).The rate of clinical postoperative recurrence is not different in i2a and i2b patients. These results suggest that the same therapeutic strategy should be used in all patients classified i2 on the Rutgeerts score whatever the location of postoperative CD recurrence.