Totally Laparoscopic Ileocolic Resection for Complex Enterovisceral Fistulas in Crohn’s Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Yehonatan Nevo ◽  
Douglas Zippel ◽  
Lior Segev ◽  
Almog Ben Yaacov ◽  
Shai Meron Eldar ◽  
...  
2020 ◽  
Author(s):  
Benichou Benjamin ◽  
Rahili Mohamed Amine ◽  
Bernard Jean Louis ◽  
Hébuterne Xavier ◽  
Schneider Stéphane ◽  
...  

Author(s):  
Giacomo Calini ◽  
Solafah Abdalla ◽  
Mohamed A. Abd El Aziz ◽  
Hamedelneel A. Saeed ◽  
Anne-Lise D. D’Angelo ◽  
...  

2019 ◽  
Vol 26 (7) ◽  
pp. 1050-1058 ◽  
Author(s):  
Robert P Hirten ◽  
Ryan C Ungaro ◽  
Daniel Castaneda ◽  
Sarah Lopatin ◽  
Bruce E Sands ◽  
...  

Abstract Background Crohn’s disease recurrence after ileocolic resection is common and graded with the Rutgeerts score. There is controversy whether anastomotic ulcers represent disease recurrence and should be included in the grading system. The aim of this study was to determine the impact of anastomotic ulcers on Crohn’s disease recurrence in patients with prior ileocolic resections. Secondary aims included defining the prevalence of anastomotic ulcers, risk factors for development, and their natural history. Methods We conducted a retrospective cohort study of patients undergoing an ileocolic resection between 2008 and 2017 at a large academic center, with a postoperative colonoscopy assessing the neoterminal ileum and ileocolic anastomosis. The primary outcome was disease recurrence defined as endoscopic recurrence (>5 ulcers in the neoterminal ileum) or need for another ileocolic resection among patients with or without an anastomotic ulcer in endoscopic remission. Results One hundred eighty-two subjects with Crohn’s disease and an ileocolic resection were included. Anastomotic ulcers were present in 95 (52.2%) subjects. No factors were associated with anastomotic ulcer development. One hundred eleven patients were in endoscopic remission on the first postoperative colonoscopy. On multivariable analysis, anastomotic ulcers were associated with disease recurrence (adjusted hazard ratio [aHR] 3.64; 95% CI, 1.21–10.95; P = 0.02). Sixty-six subjects with anastomotic ulcers underwent a second colonoscopy, with 31 patients (79.5%) having persistent ulcers independent of medication escalation. Conclusion Anastomotic ulcers occur in over half of Crohn’s disease patients after ileocolic resection. No factors are associated with their development. They are associated with Crohn’s disease recurrence and are persistent.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Elizabeth A. Spencer ◽  
Lauren Jarchin ◽  
Priya Rolfes ◽  
Sergey Khaitov ◽  
Alexander Greenstein ◽  
...  

2020 ◽  
Vol 63 (8) ◽  
pp. 1090-1101 ◽  
Author(s):  
Stephen J. O’Brien ◽  
Ryan C. Chen ◽  
Vincent T. Stephen ◽  
Jeffrey Jorden ◽  
Russell Farmer ◽  
...  

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S288-S288
Author(s):  
J Y Kim ◽  
S H Park ◽  
Y J Kim ◽  
J C Park ◽  
S Noh ◽  
...  

Abstract Background The Rutgeerts score (RS) is used to predict postoperative recurrence in Crohn’s disease (CD) patients after ileocolic resection primarily based on endoscopic finding at the neoterminal ileum. However, assessing anastomotic ulcers (AUs) is still a matter of debate. Our aim was to investigate the clinical significance of AUs on endoscopic recurrence in postoperative CD patients. Methods This was a single-centre retrospective study analysing postoperative CD patients with the RS of i0 to i1 at the first ileocolonoscopy within 1 year after ileocolic resection between 2000 and 2016 and those who underwent subsequent ileocolonoscopic follow-up. The study outcome was the clinical significance of AUs predicting endoscopic recurrence (RS ≥ i2b). Results Among 116 patients who were in endoscopic remission at the index postoperative ileocolonoscopy, 84.5% (98/116) underwent subsequent ileocolonoscopies. During the 30.0 months (interquartile ranges, 21.3–53.3) of median follow-up periods after the index ileocolonoscopy, 56.1% (55/98) showed endoscopic recurrence. Furthermore, 65.8% (48/73) with AUs and 75.5% (40/53) with major AUs defined as ulcer occupying ≥ 1/4 of the circumference or ≥ 3 ulcers confined to anastomotic ring, or any ulcers extended to ileocolic mucosa showed endoscopic recurrence. On multivariable analysis, the presence of AUs (adjusted hazard ratio [aHR], 4.33; 95% confidence interval [CI], 1.87–10.0; p < 0.001) and major AUs (aHR, 3.64; 95% CI, 1.95–6.79; p < 0.001) were associated with endoscopic recurrence, respectively. Conclusion AUs are associated with a significantly higher risk of endoscopic recurrence in postoperative CD patient who are in endoscopic remission.


2019 ◽  
Vol 22 (4) ◽  
pp. 430-438
Author(s):  
R. Bolckmans ◽  
S. Singh ◽  
K. Ratnatunga ◽  
D. Wickramasinghe ◽  
K. Sahnan ◽  
...  

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