Amicone Caroline, Marques Carla Coimbra, Reenaers Catherine, Van Kemseke Catherine, Seidel Laurence, Louis Edouard
Departement of Gastroenterology, Centre Hospitalier Universitaire de Liège, Université de Liège, Liège, Belgium.
Departement of Abdominal and Transplantation Surgery, Centre Hospitalier Universitaire de Liège, Liège, Belgium.
Gastroenterol Res Pract. 2022 Nov 1;2022:6341069. doi: 10.1155/2022/6341069. eCollection 2022.
The severity of endoscopic recurrence during the first year after intestinal resection for Crohn's disease is predictive of clinical recurrence. The aim of our study was to assess the impact of the implementation of an ileocolonoscopy during the first year after surgery on surgical recurrence.
All patients who underwent a first intestinal resection for Crohn's disease between 1992 and 2018 at the University Hospital of Liège were retrospectively included. The time to surgical recurrence was compared in three successive groups of patients operated on in the period 1992-2001 (group A), 2002-2011 (group B), and 2012-2020 (group C) using the Kaplan-Meier method and the Log-Rank test. To identify independent prognostic factors, a multivariate analysis was used via the Cox model.
223 patients (group A = 69, group B = 94, group C = 60) were included. Probabilities of surgical recurrence were significantly lower in group C (2.2% and 4.7% at 3 and 5 years, respectively) compared with group B (4.2% and 7.6% at 3 and 5 years, respectively) and with group A (9% and 18.2% at 3 and 5 years, respectively) ( = 0.0089). Ileocolonoscopy during the year after surgery was associated with a significantly reduced surgical recurrence rate in univariate and multivariate analysis (HR = 0.31, = 0.0049).
The implementation of an early ileocolonoscopy after surgery for Crohn's disease since early 2000 has been associated with a reduced surgical recurrence over the last 30 years.
克罗恩病肠道切除术后第一年内镜复发的严重程度可预测临床复发。我们研究的目的是评估术后第一年进行回结肠镜检查对手术复发的影响。
回顾性纳入1992年至2018年在列日大学医院接受首次克罗恩病肠道切除术的所有患者。使用Kaplan-Meier方法和对数秩检验比较1992 - 2001年（A组）、2002 - 2011年（B组）和2012 - 2020年（C组）连续三组手术患者的手术复发时间。为了确定独立的预后因素，通过Cox模型进行多变量分析。
纳入223例患者（A组 = 69例，B组 = 94例，C组 = 60例）。与B组（3年和5年分别为4.2%和7.6%）和A组（3年和5年分别为9%和18.2%）相比，C组手术复发概率显著更低（3年和5年分别为2.2%和4.7%）（P = 0.0089）。在单变量和多变量分析中，术后一年内进行回结肠镜检查与手术复发率显著降低相关（HR = 0.31，P = 0.0049）。
自2000年初以来，克罗恩病手术后早期进行回结肠镜检查与过去30年手术复发率降低有关。
