P557 Long-term outcomes following laparoscopic ileocecal resection without any residual lesion for Crohn’s disease: a single-center observational study

Abstract Background To describe the characteristic of Crohn’s disease (CD) patients undergoing ileocecal resection, and to analyze the long-term outcomes following surgery. Methods A retrospective study on patients undergoing ileocecal resection without any from residual disease in the remnant intestine from July 2011 to March 2020 was conducted. The clinical data and the following outcomes were evaluated. Results Among 86 CD patients, the mean disease duration was 33.4 months, 40 patients had perianal fistula. 53 patients underwent surgery due to stricture, 26 was perforation, and 7 was failure of medical therapy. 27 (31.4%) patients suffered postoperative complications. Mean follow-up was 44.4 months, 47 (54.7%) patients had an endoscopic recurrence with 9 were non-anastomotic recurrence, 20 were anastomotic recurrence, and 18 were both anastomotic and non-anastomotic recurrence, and 4 patients had a surgical recurrence. Furthermore, 41 (47.7%) had postoperative prophylaxis with 22 (25.6%) azathioprine and 17 (19.8%) infliximab. 45 (52.3%) patients were without postoperative prophylaxis, 19 (42.2%) had an endoscopic recurrence, and 26 (57.8%) had none endoscopic recurrence. The penetrating disease and lower skeletal muscle index were independent risk factors for endoscopic recurrence. Conclusion CD patients with penetrating disease or lower skeletal muscle index were suggested to have earlier postoperative prophylaxis after ileocecal resection without any from residual disease in the remnant intestine.

Download Full-text

Preoperative skeletal muscle index and visceral-to-subcutaneous fat area ratio are associated with long-term outcomes of elderly gastric cancer patients after gastrectomy

Langenbeck s Archives of Surgery ◽

10.1007/s00423-021-02092-1 ◽

2021 ◽

Author(s):

Yusuke Taki ◽

Shinsuke Sato ◽

Eiji Nakatani ◽

Kazuya Higashizono ◽

Erina Nagai ◽

...

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Cancer Patients ◽

Subcutaneous Fat ◽

Area Ratio ◽

Long Term Outcomes ◽

Skeletal Muscle Index ◽

Gastric Cancer Patients

Download Full-text

Long-term outcomes after elective ileocecal resection in children with active localized Crohn's disease—a multicenter European study

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2015.03.054 ◽

2015 ◽

Vol 50 (10) ◽

pp. 1630-1635 ◽

Cited By ~ 8

Author(s):

Iva Hojsak ◽

Sanja Kolacek ◽

Lars Folmer Hansen ◽

Jiri Bronsky ◽

Maija Piekkala ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Ileocecal Resection ◽

European Study ◽

Long Term Outcomes

Download Full-text

Experiences with the Kono-S anastomosis in Crohn’s disease of the terminal ileum—a cohort study

Langenbeck s Archives of Surgery ◽

10.1007/s00423-020-01998-6 ◽

2020 ◽

Author(s):

K. Horisberger ◽

D. L. Birrer ◽

A. Rickenbacher ◽

M. Turina

Keyword(s):

Cohort Study ◽

Crohn’S Disease ◽

Postoperative Complications ◽

Crohn's Disease ◽

Terminal Ileum ◽

Ileocecal Resection ◽

Anastomotic Recurrence ◽

Short Term ◽

Recurrence Rates

Abstract Purpose The most frequent long-term complication after ileocecal resection in Crohn’s disease is anastomotic recurrence and subsequent stenosis. Recurrence typically begins at the site of the anastomosis, raising the question of whether the surgical technique of the anastomosis could affect recurrence rates. Kono-S anastomosis is a hand-sewn antimesenteric functional end-to-end anastomosis that offers a wide lumen that is well accessible for endoscopic dilatation. The purpose of our study is to review the rate of postoperative complications almost 2 years after the introduction of this technique. Materials and methods This is a prospective single-center cohort study of all consecutive patients with Crohn’s disease undergoing ileocecal resection. Patients’ characteristics as well as specific data for the surgical procedure and short-term outcome were evaluated. Results Thirty patients were operated for Crohn’s disease of the terminal ileum (n = 24) or anastomotic recurrence (n = 6). Postoperative complications with a Clavien-Dindo Score ≥ IIIb were observed in three patients. One patient showed a hemorrhage and underwent surgical hemostasis. Two patients developed anastomotic leakage; in both cases, ileostomy was created after resection of the anastomosis. The median hospital stay was 9 days (IQR 7–12). A comparison with a historic group of conventionally operated patients of our hospital revealed no differences in short-term results except for the duration of surgery. Conclusion The Kono-S anastomosis is associated with acceptable short-term results, complications, and recurrence rates comparable with the established anastomotic techniques. Longer operation times are observed, but the few published studies concerning long-term recurrence are promising.

Download Full-text

Postoperative Endoscopic Recurrence on the Neoterminal Ileum But Not on the Anastomosis Is Mainly Driving Long-Term Outcomes in Crohn's Disease

The American Journal of Gastroenterology ◽

10.14309/ajg.0000000000000638 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Nassim Hammoudi ◽

Claire Auzolle ◽

My-Linh Tran Minh ◽

Gilles Boschetti ◽

Madeleine Bezault ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Long Term Outcomes ◽

Endoscopic Recurrence

Download Full-text

OP04 Long-term outcomes after ileocolonic resection in Crohn’s disease according to the severity of early endoscopic recurrence

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.003 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S004-S005

Author(s):

N Hammoudi ◽

C Auzolle ◽

M L Tran Minh ◽

G Boschetti ◽

M Bezault ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Clinical Relapse ◽

Recurrence Free Survival ◽

Long Term Outcomes ◽

Clinical Recurrence ◽

Free Survival ◽

Endoscopic Recurrence ◽

Ileocolonic Resection

Abstract Background Early ileocolonoscopy within the first year after surgery is the gold standard to evaluate post-operative recurrence after ileocolonic resection for Crohn’s disease (CD). The aim of the study was to evaluate the association between lesions at ileocolonoscopy 6 months after surgery and long-term outcomes. Methods The REMIND group conducted a prospective multicentre study. Patients operated for ileal or ileocolonic CD were included. An ileocolonoscopy was performed 6 months after surgery. An endoscopic classification separating anastomotic and ileal lesions was built (Ax for anastomotic lesions; Ix for neo-terminal ileum lesions evaluated according to the Rutggerts score). Clinical relapse was defined by CD-related symptoms confirmed by imaging, endoscopy or therapeutic intensification, CD-related complication or subsequent surgery. Results A total of 225 patients were included. Long-term data were available for 193 patients (86%). Median follow-up was 3.82 years (IQR:2.56–5.41) from surgery. Median clinical recurrence-free survival was 47.6 months. Clinical recurrence-free survival was significantly shorter in patients with ileal lesions at early post-operative endoscopy whatever their severity (I1 or I2I3I4) compared with patients without (I0) (median survivals: 68.5, 33.0 and 39.1 months, respectively, for I0, I1 and I2I3I4; I0 vs. I2I3I4: p = 0.0003; I0 vs. I1: p = 0.0008 and I1 vs. I2I3I4: p = 0.43). Patients with at least semi-circumferential anastomotic ulcerations (A2 or A3) had more anastomotic occlusive manifestations than patients without (A0 or A1) (A0 vs. A2A3: p = 0.01; A0 vs. A1: p = 0.83; A1 vs. A2A3: p = 0.05). Conclusion A classification separating anastomotic and ileal lesions might be more appropriate to define post-operative endoscopic recurrence. Patients with ileal lesions, including mild ones (I1), could beneficiate from treatment step up to improve long-term outcome.

Download Full-text