Gastrointestinal Tract - Original Article

Predictors of endoscopic recurrence in resected patients with Crohn’s disease in a long-term follow-up cohort: History of multiple previous resections and residual synchronous disease in the remnant intestine

Volume 31 · Issue 4 Publish Date: April 15, 2020
Yusuf Erzin Gürhan Şişman İbrahim Hatemi Bilgi Baca İsmail Hamzaoglu Ahmet Dirican Uğur Korman Aykut F. Çelik
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Turkish Journal of Gastroenterology

Volume 31 · Issue 4

Pages: 282-288

History

Published Online: April 15, 2020

Copyright © 2020 Yusuf Erzin, Gürhan Şişman, İbrahim Hatemi, Bilgi Baca, İsmail Hamzaoglu, Ahmet Dirican, Uğur Korman, Aykut F. Çelik

Yusuf Erzin
Department of Gastroenterology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
Gürhan Şişman
Department of Gastroenterology, Acıbadem University School of Medicine, İstanbul, Turkey
İbrahim Hatemi
Departments of Gastroenterology, İstanbul University Cerrahpaşa Medical Faculty, İstanbul
Bilgi Baca
Department of General Surgery, İstanbul University Cerrahpaşa Medical School, Istanbul
İsmail Hamzaoglu
Department of General Surgery, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
Ahmet Dirican
Department of Biostatistics, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
Uğur Korman
Department of Radiology, İstanbul University, Cerrahpaşa School of Medicine, İstanbul
Aykut F. Çelik
Department of Gastroenterology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
Erzin, Y., Şişman, G., Hatemi, İbrahim, Baca, B., Hamzaoglu, İsmail, Dirican, A., … Çelik, A. F. (2020). Predictors of endoscopic recurrence in resected patients with Crohn’s disease in a long-term follow-up cohort: History of multiple previous resections and residual synchronous disease in the remnant intestine. Turkish Journal of Gastroenterology, 31(4), 282–288. https://doi.org/10.5152/tjg.2020.136680
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Abstract

Background/Aims: This study aimed to determine the predictors of endoscopic recurrence in a cohort of patients with Crohn’s disease (CD) with prior intestinal resections. Materials and Methods: The charts of the patients with CD were reviewed in a retrospective manner. Eighty-three patients were eligible for the final analysis. Demographic features of these patients and time between resection and colonoscopy, presence of any macroscopic residual disease in the remnant intestine, and postoperative medications were noted. Rutgeerts score was used to define postoperative endoscopic recurrence. Results: The patients’ mean age±SD at their final colonoscopy was 42.81±11.99 yr; and 37 of 83 patients (45%) were female. The mean follow-up time between resection and the final colonoscopy was 51.16±51.08 months. A total of 51 of 83 patients (61%) were in endoscopic remission (i0, i1); whereas 32 (39%) had an endoscopic recurrence (i2, i3, i4). History of multiple resections (χ2=6.12; p=0.013) and the presence of any postoperative residual disease in the remnant intestine (χ2=5.86; p=0.015) were risk factors; whereas the regular use of azathioprine (AZA) was significantly more common among patients without recurrence (χ2=4.515; p=0.034). In an age-sex adjusted Cox regression analysis history of multiple resections, presence of any postoperative residual disease proved to be independent risk factor for endoscopic recurrence, whereas the regular use of AZA proved to be ineffective. Conclusion: In a retrospective long-term follow-up cohort of resected patients with CD, having multiple resections for CD and the presence of any residual synchronous disease after ileocolonic resection were identified as risk factors for endoscopic recurrence; the latter was never reported in previous studies.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 31 · Issue 4
Pages 282-288
DOI 10.5152/tjg.2020.136680
History
Published Online April 15, 2020
Copyright
Copyright (c) 2020 Yusuf Erzin, Gürhan Şişman, İbrahim Hatemi, Bilgi Baca, İsmail Hamzaoglu, Ahmet Dirican, Uğur Korman, Aykut F. Çelik
Affiliations
Yusuf Erzin
Department of Gastroenterology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
Gürhan Şişman
Department of Gastroenterology, Acıbadem University School of Medicine, İstanbul, Turkey
İbrahim Hatemi
Departments of Gastroenterology, İstanbul University Cerrahpaşa Medical Faculty, İstanbul
Bilgi Baca
Department of General Surgery, İstanbul University Cerrahpaşa Medical School, Istanbul
İsmail Hamzaoglu
Department of General Surgery, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
Ahmet Dirican
Department of Biostatistics, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
Uğur Korman
Department of Radiology, İstanbul University, Cerrahpaşa School of Medicine, İstanbul
Aykut F. Çelik
Department of Gastroenterology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
Cite this Article
Erzin, Y., Şişman, G., Hatemi, İbrahim, Baca, B., Hamzaoglu, İsmail, Dirican, A., … Çelik, A. F. (2020). Predictors of endoscopic recurrence in resected patients with Crohn’s disease in a long-term follow-up cohort: History of multiple previous resections and residual synchronous disease in the remnant intestine. Turkish Journal of Gastroenterology, 31(4), 282–288. https://doi.org/10.5152/tjg.2020.136680
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