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The influence of microscopic inflammation at resection margins on early postoperative endoscopic recurrence after ileocaecal resection for Crohn's disease
Poredská K., Kunovsky L., Marek F., Kala Z., Prochazka V., Dolina J., Zboril V., Kovalcikova P., Pavlik T., Ja-Bandziev P., Pavlovsky Z., Vlazny J., Mitas L.
Language English Country Czech Republic
- MeSH
- Anastomosis, Surgical MeSH
- Surgical Wound * immunology MeSH
- Digestive System Surgical Procedures * methods adverse effects MeSH
- Crohn Disease * surgery diagnosis epidemiology immunology MeSH
- Endoscopy, Digestive System methods statistics & numerical data MeSH
- Ileocecal Valve surgery pathology MeSH
- Humans MeSH
- Follow-Up Studies MeSH
- Postoperative Complications surgery diagnosis MeSH
- Risk Factors MeSH
- Check Tag
- Humans MeSH
Background and Aims: The pathogenesis and risk factors for early postoperative endoscopic recurrence of Crohn's disease (CD) remain unclear. Thus, this study aimed to identify whether histological inflammation at the resection margins after an ileocaecal resection influences endoscopic recurrence. Methods: We have prospectively followed up patients with CD who underwent ileocaecal resection at our hospital between January 2012 and January 2018. The specimens were histologically analysed for inflammation at both of the resection margins (ileal and colonic). We evaluated whether histological results of the resection margins are correlated with endoscopic recurrence of CD based on colonoscopy 6 months after ileocaecal resection. Second, we assessed the influence of known risk factors and preoperative therapy on endoscopic recurrence of CD. Results: A total of 107 patients were included in our study. Six months after ileocaecal resection, 23 patients (21.5%) had an endoscopic recurrence of CD. The histological signs of CD at the resection margins were associated with a higher endoscopic recurrence (56.5% versus 4.8%, p < 0.001). Disease duration from diagnosis to surgery (p = 0.006) and the length of the resected bowel (p = 0.019) were significantly longer in patients with endoscopic recurrence. Smoking was also proved to be a risk factor for endoscopic recurrence (p = 0.028). Conclusions: Histological inflammation at the resection margins was significantly associated with a higher risk of early postoperative endoscopic recurrence after an ileocaecal resection for CD.
Department of Pathology University Hospital Brno Faculty of Medicine Masaryk University Brno
Department of Pediatrics University Hospital Brno Faculty of Medicine Masaryk University Brno
Department of Surgery University Hospital Brno Faculty of Medicine Masaryk University Brno
Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno
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- $a Poredská, Karolina $u Department of Gastroenterology and Internal Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno $7 xx0224966
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- $a The influence of microscopic inflammation at resection margins on early postoperative endoscopic recurrence after ileocaecal resection for Crohn's disease / $c Poredská K., Kunovsky L., Marek F., Kala Z., Prochazka V., Dolina J., Zboril V., Kovalcikova P., Pavlik T., Ja-Bandziev P., Pavlovsky Z., Vlazny J., Mitas L.
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- $a Background and Aims: The pathogenesis and risk factors for early postoperative endoscopic recurrence of Crohn's disease (CD) remain unclear. Thus, this study aimed to identify whether histological inflammation at the resection margins after an ileocaecal resection influences endoscopic recurrence. Methods: We have prospectively followed up patients with CD who underwent ileocaecal resection at our hospital between January 2012 and January 2018. The specimens were histologically analysed for inflammation at both of the resection margins (ileal and colonic). We evaluated whether histological results of the resection margins are correlated with endoscopic recurrence of CD based on colonoscopy 6 months after ileocaecal resection. Second, we assessed the influence of known risk factors and preoperative therapy on endoscopic recurrence of CD. Results: A total of 107 patients were included in our study. Six months after ileocaecal resection, 23 patients (21.5%) had an endoscopic recurrence of CD. The histological signs of CD at the resection margins were associated with a higher endoscopic recurrence (56.5% versus 4.8%, p < 0.001). Disease duration from diagnosis to surgery (p = 0.006) and the length of the resected bowel (p = 0.019) were significantly longer in patients with endoscopic recurrence. Smoking was also proved to be a risk factor for endoscopic recurrence (p = 0.028). Conclusions: Histological inflammation at the resection margins was significantly associated with a higher risk of early postoperative endoscopic recurrence after an ileocaecal resection for CD.
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