scholarly journals The Risk Factors of Surgical Recurrence in Patients With Crohn's Disease After First Intestinal Surgery

2011 ◽  
Vol 140 (5) ◽  
pp. S-281
Author(s):  
Hyun Jin Jo ◽  
Kyu Joo Park ◽  
Mi Na Kim ◽  
Jong Pil Im ◽  
Sang Gyun Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intestinal Surgery ◽  
Surgical Recurrence

scholarly journals P115 Real-world experience of peri-operative treatments on surgical complications after Ileo-caecal resection in Crohn’s disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S193-S194
Author(s):  
S Di Stefano ◽  
C Liefferinckx ◽  
A Cremer ◽  
L Amininejad ◽  
A Van Gossum ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Anastomotic Leakage ◽  
Surgical Complications ◽  
Protective Role ◽  
Infectious Complications ◽  
Surgical Recurrence ◽  
The Impact

Abstract Background The current recommendations remain vague as to whether biologics are safe or deleterious when surgery is contemplated in patients with Crohn’s disease (CD). Conflicting data do not enable to adopt a definitive position on the time to surgery. The aims of this study were to evaluate the impact of perioperative treatments on the rate of surgical complications and to report surgical recurrence rate of CD after ileo-caecal (IC) resection. Methods This was a retrospective monocentric cohort study of consecutive CD patients who underwent IC resection between 1996 and 2018. An ethical committee has been approved (P2019/376). The overall rate of surgical complications was evaluated within 30 days after surgery. The effect of pre- and postoperative treatments was assessed on overall morbidity, general and infectious complications, anastomotic leakage and risk factors. Statistical analyses were performed using SPSS. Results Demographic data of the 165 CD patients who underwent a primary IC resection are presented in Table 1. The median age at time of the first IC resection was 35 years (IQR 24–44) while the median follow-up was 6.1 years (IQR 1–11). The overall rate of complications was 18% including 8.7% and 3.3% patients with infectious complications and anastomotic leakage, respectively. No risk factors have been found to be associated with surgical complications. In particular, immunosuppressants and biologics did not increase the risk of surgical complications. Twenty-four per cent of patients (n = 39/160) needed a second IC resection due to stenosis at the anastomosis site in 69.2% of cases (n = 27/39). Surgical recurrence was found to increase linearly over time with a second surgery after a median follow-up of 8 years (IQR 2–12). Anti-TNF used as post-operative treatment had a protective role on surgical recurrence in multivariable regression with odd ration (OR) of 0.15, p = 0.001 (Table 2). Conclusion Prevalence of complications after an IC resection in CD patients was of 18% in this retrospective monocentric cohort. No risk factors were found to be associated with surgical complications. Anti-TNF seems to have a protective role on surgical recurrence.

Risk factors for first intestinal surgery in Crohn's disease

2019 ◽  
Author(s):  
G Novacek ◽  
W Reinisch ◽  
S Reinisch ◽  
C Primas ◽  
W Eigner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intestinal Surgery

scholarly journals P151 Risk factors for first intestinal surgery in Crohn’s disease

2019 ◽  
Vol 13 (Supplement_1) ◽  
pp. S165-S165
Author(s):  
G Novacek ◽  
W Reinisch ◽  
S Reinisch ◽  
C Primas ◽  
W Eigner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intestinal Surgery

scholarly journals P215 The effect of resection margin involvement of Crohn’s disease on the surgical and clinical recurrence after intestinal surgery

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S249-S249
Author(s):  
J H Seo ◽  
J L Lee
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Confidence Interval ◽  
Resection Margin ◽  
Intestinal Surgery ◽  
Repeat Surgery ◽  
Clinical Recurrence ◽  
Margin Involvement ◽  
Surgical Recurrence ◽  
Increased Risk

Abstract Background Approximately 80% of patients with Crohn’s disease (CD) require major intestinal surgery during their lifetime and a quarter of patients will undergo repeat surgery within 5 years of the index surgery. For this reason, operative treatment of CD has been the bowel-sparing approach for several decades. This study evaluated the effects of the Crohn’s disease involvement of resection margin on clinical and surgical recurrence. Methods This retrospective study analysed 803 patient who underwent intestinal surgery for CD between January 2006 and December 2015. The CD involvement of resection margin was defined as microscopic involvement from the pathologic reports and grossly involvement from the operative records. Anastomosis recurrence was reviewed using the operative records and radiologic findings including colonoscopy, computed tomography and magnetic resonance imaging. Results In total, 41 patients (5.1%) had an active CD in the bowel resection margin – 31 patients (3.9%) with histologically, 10 patients (1.2%) with grossly. We had 221 (26.8%) reoperation cases, of which 87 (10.6%) patients were an anastomotic recurrence. When patients were stratified by surgical recurrence at anastomosis, the increased risk was not significant in resection margin positive grossly (odds ratio [OR], 3.65; 95% confidence interval [CI], 0.93–14.41) and in microscopic (OR, 1.26; 95% CI, 0.43–3.70) comparing with negative resection margin. Also, resection margin involvement was not related with clinical recurrence grossly (OR, 0.30; 95% confidence interval [CI], 0.07–1.26) and in microscopic (OR, 0.50; 95% CI, 0.21–1.17) Conclusion The current practice suggests the CD involvement of resection margin, even grossly or microscopic, do not influence surgical and clinical recurrence.

scholarly journals Cross-disorder analysis of schizophrenia and 19 immune-mediated diseases identifies shared genetic risk

2019 ◽  
Vol 28 (20) ◽  
pp. 3498-3513 ◽  
Author(s):  
Jennie G Pouget ◽  
Buhm Han ◽  
Yang Wu ◽  
Emmanuel Mignot ◽  
Hanna M Ollila ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Genetic Risk ◽  
Genetic Risk Factors ◽  
Phenotypic Correlation ◽  
Biliary Cirrhosis ◽  
Genome Wide ◽  
Shared Genetic

Abstract Many immune diseases occur at different rates among people with schizophrenia compared to the general population. Here, we evaluated whether this phenomenon might be explained by shared genetic risk factors. We used data from large genome-wide association studies to compare the genetic architecture of schizophrenia to 19 immune diseases. First, we evaluated the association with schizophrenia of 581 variants previously reported to be associated with immune diseases at genome-wide significance. We identified five variants with potentially pleiotropic effects. While colocalization analyses were inconclusive, functional characterization of these variants provided the strongest evidence for a model in which genetic variation at rs1734907 modulates risk of schizophrenia and Crohn’s disease via altered methylation and expression of EPHB4—a gene whose protein product guides the migration of neuronal axons in the brain and the migration of lymphocytes towards infected cells in the immune system. Next, we investigated genome-wide sharing of common variants between schizophrenia and immune diseases using cross-trait LD score regression. Of the 11 immune diseases with available genome-wide summary statistics, we observed genetic correlation between six immune diseases and schizophrenia: inflammatory bowel disease (rg = 0.12 ± 0.03, P = 2.49 × 10−4), Crohn’s disease (rg = 0.097 ± 0.06, P = 3.27 × 10−3), ulcerative colitis (rg = 0.11 ± 0.04, P = 4.05 × 10–3), primary biliary cirrhosis (rg = 0.13 ± 0.05, P = 3.98 × 10−3), psoriasis (rg = 0.18 ± 0.07, P = 7.78 × 10–3) and systemic lupus erythematosus (rg = 0.13 ± 0.05, P = 3.76 × 10–3). With the exception of ulcerative colitis, the degree and direction of these genetic correlations were consistent with the expected phenotypic correlation based on epidemiological data. Our findings suggest shared genetic risk factors contribute to the epidemiological association of certain immune diseases and schizophrenia.

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