PREDICTIVE FACTORS OF ENDOSCOPIC RECURRENCE AFTER ILEOCOLIC RESECTION FOR CROHN´S DISEASE

Aims To evaluate the risk factors for endoscopic recurrence after bowel resection in Crohn´s disease (CD).

Methods We conducted a retrospective and analytical study including all patients with Crohn´s disease who had surgery over a period of 4 years, from 2014 to2018,Endoscopic recurrence was defined by a Rutgeets score > or equal to I2.

Results Our study included 55 patients (31 men and 24 women) . The mean age of our patients was 34.65 years [15–76] with an average age at surgery of 30, 8 years, the mean time between diagnosis of (CD) and surgery was 74.18 months . 11 patients were smokers (20%). According to the Montreal classification, the disease was ileal in 39 cases (70.9%), ileocolic in 15 cases (27.2%), and colic in 1 case (1.8%) .The phenotype of CD was strituring in 65.4 % of cases and penetrating in 30.9% of cases, with the presence of ano-perineal manifestations in 9 cases (16.3%) . 13 patients had an anterior resection (23.63%). The indication of surgery was urgent in 81.1% of cases, 15 patients (27.2%) received a corticosteroid therapy before the surgical procedure. Postoperative colonoscopy was performed before 1 year in 70% of cases and beyond 1 year in 30% of cases, the Rutgeerts score was < I2 in 18 patients (32.7%), and > or equal to I2 in 36 cases (65.4%). 43 patients (78.18%) have had medical treatment after surgery,The univariate analysis showed a statistically significant relationship between the presence of extra-intestinal manifestations and postoperative endoscopic recurrence (p: 0.03).

Conclusions Two-thirds of patients with CD will need surgery in their lifetime. Ileocecal resection does not cure the disease, but allows a satisfactory control of lesions and a more or less long remission time. The endoscopic recurrence rate in our study was of 65% mainly being related to the presence of extra-intestinal manifestations.

 

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