Fate of ileorectal anastomosis for treating Crohn's disease in the era of biologics: Results from a French retrospective multicentre cohort study
Fuente:
Wiley Open Access
Gespeichert in:
| Hauptverfasser: | , , , , , , , , , , |
|---|---|
| Format: | Artículo Open Access |
| Veröffentlicht: |
Wiley
2024
|
| Schlagworte: | |
| Online-Zugang: | |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| _version_ | 1867013107530858496 |
|---|---|
| author | Juba Ait Mohand Arnaud Alves Antoine Brouquet Adeline Germain Valerie Bridoux Bertrand Trilling Etienne Buscail Caroline Valibouze Maxime Leroy Pierre Desreumaux Philippe Zerbib |
| author_facet | Juba Ait Mohand Arnaud Alves Antoine Brouquet Adeline Germain Valerie Bridoux Bertrand Trilling Etienne Buscail Caroline Valibouze Maxime Leroy Pierre Desreumaux Philippe Zerbib Juba Ait Mohand Arnaud Alves Antoine Brouquet Adeline Germain Valerie Bridoux Bertrand Trilling Etienne Buscail Caroline Valibouze Maxime Leroy Pierre Desreumaux Philippe Zerbib |
| collection | Wiley Open Access |
| contents | Fate of ileorectal anastomosis for treating Crohn's disease in the era of biologics: Results from a French retrospective multicentre cohort study Juba Ait Mohand Arnaud Alves Antoine Brouquet Adeline Germain Valerie Bridoux Bertrand Trilling Etienne Buscail Caroline Valibouze Maxime Leroy Pierre Desreumaux Philippe Zerbib Colorectal Disease AbstractAimThe rate of surgical recurrence following ileorectal anastomosis (IRA) in patients with Crohn's disease (CD) remains poorly understood. Most studies were conducted before the advent of biologics. Our aim was to assess the fate of IRA in patients with CD during the biologics era and identify risk factors for endoscopic, clinical, and surgical recurrence.MethodsThis retrospective multicentre cohort study included patients with CD who underwent IRA between 2006 and 2022. The association of patient characteristics and postoperative measures with each type of postoperative recurrence and need for a definitive stoma was investigated using the chi‐square test or Fisher's exact test.ResultsDuring a median follow‐up period of 60 months, the rates of endoscopic, clinical, and surgical postoperative recurrence were 70%, 59%, and 35%, respectively. The rate of perianal lesions was higher in patients who underwent a definitive stoma (70% vs. 35%, p = 0.007) and with endoscopic (50% vs. 25%, p = 0.038), clinical (54% vs. 24%, p = 0.006), and surgical (63% vs. 34%, p = 0.015) recurrence. The incidence of residual microscopic disease at the rectal margin was higher in patients with endoscopic recurrence (p = 0.047). Biologics were identified as protective factors against the need for a definitive stoma (p = 0.044).ConclusionIRA is a good treatment option for extensive colitis in patients with CD. However, its consideration should be weighed in the presence of perianal lesions, which have been shown to be a risk factor for delayed proctectomy. 10.1111/codi.17185 http://creativecommons.org/licenses/by/4.0/ |
| doi_str_mv | 10.1111/codi.17185 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_codi_17185 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Fate of ileorectal anastomosis for treating Crohn's disease in the era of biologics: Results from a French retrospective multicentre cohort study Juba Ait Mohand Arnaud Alves Antoine Brouquet Adeline Germain Valerie Bridoux Bertrand Trilling Etienne Buscail Caroline Valibouze Maxime Leroy Pierre Desreumaux Philippe Zerbib Colorectal Disease Fate of ileorectal anastomosis for treating Crohn's disease in the era of biologics: Results from a French retrospective multicentre cohort study Juba Ait Mohand Arnaud Alves Antoine Brouquet Adeline Germain Valerie Bridoux Bertrand Trilling Etienne Buscail Caroline Valibouze Maxime Leroy Pierre Desreumaux Philippe Zerbib Colorectal Disease AbstractAimThe rate of surgical recurrence following ileorectal anastomosis (IRA) in patients with Crohn's disease (CD) remains poorly understood. Most studies were conducted before the advent of biologics. Our aim was to assess the fate of IRA in patients with CD during the biologics era and identify risk factors for endoscopic, clinical, and surgical recurrence.MethodsThis retrospective multicentre cohort study included patients with CD who underwent IRA between 2006 and 2022. The association of patient characteristics and postoperative measures with each type of postoperative recurrence and need for a definitive stoma was investigated using the chi‐square test or Fisher's exact test.ResultsDuring a median follow‐up period of 60 months, the rates of endoscopic, clinical, and surgical postoperative recurrence were 70%, 59%, and 35%, respectively. The rate of perianal lesions was higher in patients who underwent a definitive stoma (70% vs. 35%, p = 0.007) and with endoscopic (50% vs. 25%, p = 0.038), clinical (54% vs. 24%, p = 0.006), and surgical (63% vs. 34%, p = 0.015) recurrence. The incidence of residual microscopic disease at the rectal margin was higher in patients with endoscopic recurrence (p = 0.047). Biologics were identified as protective factors against the need for a definitive stoma (p = 0.044).ConclusionIRA is a good treatment option for extensive colitis in patients with CD. However, its consideration should be weighed in the presence of perianal lesions, which have been shown to be a risk factor for delayed proctectomy. 10.1111/codi.17185 http://creativecommons.org/licenses/by/4.0/ |
| title | Fate of ileorectal anastomosis for treating Crohn's disease in the era of biologics: Results from a French retrospective multicentre cohort study |
| topic | Colorectal Disease |
| url | https://onlinelibrary.wiley.com/doi/10.1111/codi.17185 |