Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Endoscopic Progression After Ileocolonic Resection

Gastrointest Endosc; ePub 2019 Feb 6; Ollech, et al

Endoscopic lesions limited to the ileocolonic anastomosis (RS i2a) in patients with Crohn’s disease (CD) undergoing colonoscopy within 1 year of their resection were not associated with a significantly higher rate of progression to move severe disease, a new study found. The retrospective single-center study included all consecutive eligible patients between 2004 and 2014. Demographics, disease, and treatment data were collected. Researchers found:

  • 277 CD patients (median age 36 years) had an ileocolonoscopy ≤12 months after ileocolonic resection.
  • At index colonoscopy, 95 patients (45.9%) had a RS i0, 31 (14.9%) i1, 40 (19.3%) i2a, 25 (12.1%) i2B, 10 (4.8%) i3, and 6 (2.9%) i4.
  • 191 patients had a RS of i0-i2 and were included in the analyses for recurrent surgery.
  • 149 patients were included in the analysis for the primary outcome of endoscopic disease progression.
  • Patients with i2a lesions were not found to have a significantly elevated risk of recurrent surgery (HR, 1.43).

Citation:

Ollech JE, Aharoni-Golan M, Weisshof R, et al. Differential risk of disease progression between isolated anastomotic ulcers and mild ileal recurrence after ileocolonic resection in patients with Crohn’s disease. [Published online ahead of print February 6, 2019]. Gastrointest Endosc. doi:10.1016/j.gie.2019.01.029.