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Erschienen in: Journal of Gastrointestinal Surgery 8/2012

01.08.2012 | Original Article

Frequency and Risk Factors of Postoperative Recurrence of Crohn’s Disease After Intestinal Resection in the Chinese Population

verfasst von: Yi Li, Weiming Zhu, Lugen Zuo, Wei Zhang, Jianfeng Gong, Lili Gu, Lei Cao, Ning Li, Jieshou Li

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 8/2012

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Abstract

Background

Data on risk factors of postoperative recurrence in patients with Crohn’s disease (CD) have shown conflicting results. The aim of this retrospective study is to identify predictors of early symptomatic recurrence of CD after surgical intestinal resection in the Chinese population.

Materials and Methods

Patients diagnosed as CD who underwent intestinal resection in Jinling Hospital between May 2004 and December 2010 were included in our study. Clinical data of these patients were reviewed. Multivariable survival analysis was performed to elucidate risk factors of early postoperative symptomatic recurrence.

Results

There were a total of 141 CD patients who had at least one previous curative resection for CD under regular follow-up in our unit. Our data indicated disease behavior (95 % CI 1.01–1.70, P = 0.044), smoking habits (95 % CI 1.32–2.84, P = 0.001), indication of perforation (95 % CI 1.09–4.02, P = 0.026), and location of anastomosis (95 % CI 1.09–3.39, P = 0.023) which are, as a result, strong independent predictors of symptomatic recurrence, while the anastomosis type as side-to-side anastomosis (SSA) was significantly associated with a decreased risk of symptomatic recurrence when compared with other anastomosis type (95 % CI 0.26–0.94, P = 0.038). Medical prophylaxes also played a role in the prevention of postoperative symptomatic recurrence.

Conclusions

A smoking habits and perforation indication for surgery at the time of resection are associated with an increased risk of symptomatic recurrence. Anastomosis type with SSA is associated with a reduced risk of symptomatic recurrence. This population-based study supports the concept that environmental factors, disease character, and surgical technique influence the risk of postoperative symptomatic recurrence of CD.
Literatur
1.
Zurück zum Zitat Leong RW, Lau JY, Sung JJ. The epidemiology and phenotype of Crohn’s disease in the Chinese population. Inflamm Bowel Dis 2004;10(5):646–51.PubMedCrossRef Leong RW, Lau JY, Sung JJ. The epidemiology and phenotype of Crohn’s disease in the Chinese population. Inflamm Bowel Dis 2004;10(5):646–51.PubMedCrossRef
2.
Zurück zum Zitat Solberg IC, Vatn MH, Hoie O, Stray N, Sauar J, Jahnsen J, et al. Clinical course in Crohn’s disease: results of a Norwegian population-based ten-year follow-up study. Clin Gastroenterol Hepatol 2007;5(12):1430–8.PubMedCrossRef Solberg IC, Vatn MH, Hoie O, Stray N, Sauar J, Jahnsen J, et al. Clinical course in Crohn’s disease: results of a Norwegian population-based ten-year follow-up study. Clin Gastroenterol Hepatol 2007;5(12):1430–8.PubMedCrossRef
3.
Zurück zum Zitat Sachar DB. The problem of postoperative recurrence of Crohn’s disease. Med Clin North Am 1990;74(1):183–8.PubMed Sachar DB. The problem of postoperative recurrence of Crohn’s disease. Med Clin North Am 1990;74(1):183–8.PubMed
4.
Zurück zum Zitat Ng SC, Kamm MA. Management of postoperative Crohn’s disease. Am J Gastroenterol 2008;103(4):1029–35.PubMedCrossRef Ng SC, Kamm MA. Management of postoperative Crohn’s disease. Am J Gastroenterol 2008;103(4):1029–35.PubMedCrossRef
5.
Zurück zum Zitat Lindberg E, Jarnerot G, Huitfeldt B. Smoking in Crohn’s disease: effect on localisation and clinical course. Gut 1992;33(6):779–82.PubMedCrossRef Lindberg E, Jarnerot G, Huitfeldt B. Smoking in Crohn’s disease: effect on localisation and clinical course. Gut 1992;33(6):779–82.PubMedCrossRef
6.
Zurück zum Zitat Williams JG, Wong WD, Rothenberger DA, Goldberg SM. Recurrence of Crohn’s disease after resection. Br J Surg 1991;78(1):10–9.PubMedCrossRef Williams JG, Wong WD, Rothenberger DA, Goldberg SM. Recurrence of Crohn’s disease after resection. Br J Surg 1991;78(1):10–9.PubMedCrossRef
7.
Zurück zum Zitat Alvarez-Lobos M, Arostegui JI, Sans M, Tassies D, Plaza S, Delgado S, et al. Crohn’s disease patients carrying Nod2/CARD15 gene variants have an increased and early need for first surgery due to stricturing disease and higher rate of surgical recurrence. Ann Surg 2005;242(5):693–700.PubMedCrossRef Alvarez-Lobos M, Arostegui JI, Sans M, Tassies D, Plaza S, Delgado S, et al. Crohn’s disease patients carrying Nod2/CARD15 gene variants have an increased and early need for first surgery due to stricturing disease and higher rate of surgical recurrence. Ann Surg 2005;242(5):693–700.PubMedCrossRef
8.
Zurück zum Zitat Caprilli R, Gassull MA, Escher JC, Moser G, Munkholm P, Forbes A, et al. European evidence based consensus on the diagnosis and management of Crohn’s disease: special situations. Gut 2006;55 Suppl 1:i36–58.PubMedCrossRef Caprilli R, Gassull MA, Escher JC, Moser G, Munkholm P, Forbes A, et al. European evidence based consensus on the diagnosis and management of Crohn’s disease: special situations. Gut 2006;55 Suppl 1:i36–58.PubMedCrossRef
9.
Zurück zum Zitat Bernell O, Lapidus A, Hellers G. Risk factors for surgery and recurrence in 907 patients with primary ileocaecal Crohn’s disease. Br J Surg 2000;87(12):1697–701.PubMedCrossRef Bernell O, Lapidus A, Hellers G. Risk factors for surgery and recurrence in 907 patients with primary ileocaecal Crohn’s disease. Br J Surg 2000;87(12):1697–701.PubMedCrossRef
10.
Zurück zum Zitat Travis SP, Stange EF, Lemann M, Oresland T, Chowers Y, Forbes A, et al. European evidence based consensus on the diagnosis and management of Crohn’s disease: current management. Gut 2006;55 Suppl 1:i16–35.PubMedCrossRef Travis SP, Stange EF, Lemann M, Oresland T, Chowers Y, Forbes A, et al. European evidence based consensus on the diagnosis and management of Crohn’s disease: current management. Gut 2006;55 Suppl 1:i16–35.PubMedCrossRef
11.
Zurück zum Zitat Yamamoto T, Keighley MR. Smoking and disease recurrence after operation for Crohn’s disease. Br J Surg 2000;87(4):398–404.PubMedCrossRef Yamamoto T, Keighley MR. Smoking and disease recurrence after operation for Crohn’s disease. Br J Surg 2000;87(4):398–404.PubMedCrossRef
12.
Zurück zum Zitat Fichera A, McCormack R, Rubin MA, Hurst RD, Michelassi F. Long-term outcome of surgically treated Crohn’s colitis: a prospective study. Dis Colon Rectum 2005;48(5):963–9.PubMedCrossRef Fichera A, McCormack R, Rubin MA, Hurst RD, Michelassi F. Long-term outcome of surgically treated Crohn’s colitis: a prospective study. Dis Colon Rectum 2005;48(5):963–9.PubMedCrossRef
13.
Zurück zum Zitat Scarpa M, Angriman I, Barollo M, Polese L, Ruffolo C, Bertin M, et al. Role of stapled and hand-sewn anastomoses in recurrence of Crohn’s disease. Hepatogastroenterology 2004;51(58):1053–7.PubMed Scarpa M, Angriman I, Barollo M, Polese L, Ruffolo C, Bertin M, et al. Role of stapled and hand-sewn anastomoses in recurrence of Crohn’s disease. Hepatogastroenterology 2004;51(58):1053–7.PubMed
14.
Zurück zum Zitat Scarpa M, Ruffolo C, Bertin E, Polese L, Filosa T, Prando D, et al. Surgical predictors of recurrence of Crohn’s disease after ileocolonic resection. Int J Colorectal Dis 2007;22(9):1061–9.PubMedCrossRef Scarpa M, Ruffolo C, Bertin E, Polese L, Filosa T, Prando D, et al. Surgical predictors of recurrence of Crohn’s disease after ileocolonic resection. Int J Colorectal Dis 2007;22(9):1061–9.PubMedCrossRef
15.
Zurück zum Zitat Unkart JT, Anderson L, Li E, Miller C, Yan Y, Gu CC, et al. Risk factors for surgical recurrence after ileocolic resection of Crohn’s disease. Dis Colon Rectum 2008;51(8):1211–6.PubMedCrossRef Unkart JT, Anderson L, Li E, Miller C, Yan Y, Gu CC, et al. Risk factors for surgical recurrence after ileocolic resection of Crohn’s disease. Dis Colon Rectum 2008;51(8):1211–6.PubMedCrossRef
16.
Zurück zum Zitat Yamamoto T. Factors affecting recurrence after surgery for Crohn’s disease. World J Gastroenterol 2005;11(26):3971–9.PubMed Yamamoto T. Factors affecting recurrence after surgery for Crohn’s disease. World J Gastroenterol 2005;11(26):3971–9.PubMed
17.
Zurück zum Zitat Egan LJ, Sandborn WJ. Advances in the treatment of Crohn’s disease. Gastroenterology 2004;126(6):1574–81.PubMedCrossRef Egan LJ, Sandborn WJ. Advances in the treatment of Crohn’s disease. Gastroenterology 2004;126(6):1574–81.PubMedCrossRef
18.
Zurück zum Zitat Cottone M, Orlando A, Modesto I. Postoperative maintenance therapy for inflammatory bowel disease. Curr Opin Gastroenterol 2006;22(4):377–81.PubMedCrossRef Cottone M, Orlando A, Modesto I. Postoperative maintenance therapy for inflammatory bowel disease. Curr Opin Gastroenterol 2006;22(4):377–81.PubMedCrossRef
19.
Zurück zum Zitat Markowitz J, Markowitz JE, Bousvaros A, Crandall W, Faubion W, Kirschner BS, et al. Workshop report: prevention of postoperative recurrence in Crohn’s disease. J Pediatr Gastroenterol Nutr 2005;41(2):145–51.PubMedCrossRef Markowitz J, Markowitz JE, Bousvaros A, Crandall W, Faubion W, Kirschner BS, et al. Workshop report: prevention of postoperative recurrence in Crohn’s disease. J Pediatr Gastroenterol Nutr 2005;41(2):145–51.PubMedCrossRef
20.
Zurück zum Zitat Li Y, Mao Q, Shen L, Tian Y, Yu C, Zhu WM, et al. Interleukin-23 receptor genetic polymorphisms and Crohn’s disease susceptibility: a meta-analysis. Inflamm Res;59(8):607–14. Li Y, Mao Q, Shen L, Tian Y, Yu C, Zhu WM, et al. Interleukin-23 receptor genetic polymorphisms and Crohn’s disease susceptibility: a meta-analysis. Inflamm Res;59(8):607–14.
21.
Zurück zum Zitat Lautenbach E, Berlin JA, Lichtenstein GR. Risk factors for early postoperative recurrence of Crohn’s disease. Gastroenterology 1998;115(2):259–67.PubMedCrossRef Lautenbach E, Berlin JA, Lichtenstein GR. Risk factors for early postoperative recurrence of Crohn’s disease. Gastroenterology 1998;115(2):259–67.PubMedCrossRef
22.
Zurück zum Zitat Rutgeerts P, Geboes K, Vantrappen G, Kerremans R, Coenegrachts JL, Coremans G. Natural history of recurrent Crohn’s disease at the ileocolonic anastomosis after curative surgery. Gut 1984;25(6):665–72.PubMedCrossRef Rutgeerts P, Geboes K, Vantrappen G, Kerremans R, Coenegrachts JL, Coremans G. Natural history of recurrent Crohn’s disease at the ileocolonic anastomosis after curative surgery. Gut 1984;25(6):665–72.PubMedCrossRef
23.
Zurück zum Zitat Rutgeerts P, Geboes K, Vantrappen G, Beyls J, Kerremans R, Hiele M. Predictability of the postoperative course of Crohn’s disease. Gastroenterology 1990;99(4):956–63.PubMed Rutgeerts P, Geboes K, Vantrappen G, Beyls J, Kerremans R, Hiele M. Predictability of the postoperative course of Crohn’s disease. Gastroenterology 1990;99(4):956–63.PubMed
24.
Zurück zum Zitat Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006;55(6):749–53.PubMedCrossRef Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006;55(6):749–53.PubMedCrossRef
25.
Zurück zum Zitat Cottone M, Rosselli M, Orlando A, Oliva L, Puleo A, Cappello M, et al. Smoking habits and recurrence in Crohn’s disease. Gastroenterology 1994;106(3):643–8.PubMed Cottone M, Rosselli M, Orlando A, Oliva L, Puleo A, Cappello M, et al. Smoking habits and recurrence in Crohn’s disease. Gastroenterology 1994;106(3):643–8.PubMed
26.
Zurück zum Zitat McLeod RS, Wolff BG, Ross S, Parkes R, McKenzie M. Recurrence of Crohn’s disease after ileocolic resection is not affected by anastomotic type: results of a multicenter, randomized, controlled trial. Dis Colon Rectum 2009;52(5):919–27.PubMedCrossRef McLeod RS, Wolff BG, Ross S, Parkes R, McKenzie M. Recurrence of Crohn’s disease after ileocolic resection is not affected by anastomotic type: results of a multicenter, randomized, controlled trial. Dis Colon Rectum 2009;52(5):919–27.PubMedCrossRef
27.
Zurück zum Zitat Moskovitz D, McLeod RS, Greenberg GR, Cohen Z. Operative and environmental risk factors for recurrence of Crohn’s disease. Int J Colorectal Dis 1999;14(4–5):224–6.PubMedCrossRef Moskovitz D, McLeod RS, Greenberg GR, Cohen Z. Operative and environmental risk factors for recurrence of Crohn’s disease. Int J Colorectal Dis 1999;14(4–5):224–6.PubMedCrossRef
28.
Zurück zum Zitat Van Assche G, Dignass A, Reinisch W, van der Woude CJ, Sturm A, De Vos M, et al. The second European evidence-based Consensus on the diagnosis and management of Crohn’s disease: Special situations. J Crohns Colitis;4(1):63–101. Van Assche G, Dignass A, Reinisch W, van der Woude CJ, Sturm A, De Vos M, et al. The second European evidence-based Consensus on the diagnosis and management of Crohn’s disease: Special situations. J Crohns Colitis;4(1):63–101.
29.
Zurück zum Zitat Louis E, Collard A, Oger AF, Degroote E, Aboul Nasr El Yafi FA, Belaiche J. Behaviour of Crohn’s disease according to the Vienna classification: changing pattern over the course of the disease. Gut 2001;49(6):777–82.PubMedCrossRef Louis E, Collard A, Oger AF, Degroote E, Aboul Nasr El Yafi FA, Belaiche J. Behaviour of Crohn’s disease according to the Vienna classification: changing pattern over the course of the disease. Gut 2001;49(6):777–82.PubMedCrossRef
30.
Zurück zum Zitat Simillis C, Yamamoto T, Reese GE, Umegae S, Matsumoto K, Darzi AW, et al. A meta-analysis comparing incidence of recurrence and indication for reoperation after surgery for perforating versus nonperforating Crohn’s disease. Am J Gastroenterol 2008;103(1):196–205.PubMedCrossRef Simillis C, Yamamoto T, Reese GE, Umegae S, Matsumoto K, Darzi AW, et al. A meta-analysis comparing incidence of recurrence and indication for reoperation after surgery for perforating versus nonperforating Crohn’s disease. Am J Gastroenterol 2008;103(1):196–205.PubMedCrossRef
31.
Zurück zum Zitat Sachar DB, Lemmer E, Ibrahim C, Edden Y, Ullman T, Ciardulo J, et al. Recurrence patterns after first resection for stricturing or penetrating Crohn’s disease. Inflamm Bowel Dis 2009;15(7):1071–5.PubMedCrossRef Sachar DB, Lemmer E, Ibrahim C, Edden Y, Ullman T, Ciardulo J, et al. Recurrence patterns after first resection for stricturing or penetrating Crohn’s disease. Inflamm Bowel Dis 2009;15(7):1071–5.PubMedCrossRef
32.
Zurück zum Zitat Greenstein AJ, Lachman P, Sachar DB, Springhorn J, Heimann T, Janowitz HD, et al. Perforating and non-perforating indications for repeated operations in Crohn’s disease: evidence for two clinical forms. Gut 1988;29(5):588–92.PubMedCrossRef Greenstein AJ, Lachman P, Sachar DB, Springhorn J, Heimann T, Janowitz HD, et al. Perforating and non-perforating indications for repeated operations in Crohn’s disease: evidence for two clinical forms. Gut 1988;29(5):588–92.PubMedCrossRef
33.
Zurück zum Zitat Fritz T, Niederreiter L, Adolph T, Blumberg RS, Kaser A. Crohn’s disease: NOD2, autophagy and ER stress converge. Gut;60(11):1580–8. Fritz T, Niederreiter L, Adolph T, Blumberg RS, Kaser A. Crohn’s disease: NOD2, autophagy and ER stress converge. Gut;60(11):1580–8.
34.
Zurück zum Zitat Ryan WR, Allan RN, Yamamoto T, Keighley MR. Crohn’s disease patients who quit smoking have a reduced risk of reoperation for recurrence. Am J Surg 2004;187(2):219–25.PubMedCrossRef Ryan WR, Allan RN, Yamamoto T, Keighley MR. Crohn’s disease patients who quit smoking have a reduced risk of reoperation for recurrence. Am J Surg 2004;187(2):219–25.PubMedCrossRef
35.
Zurück zum Zitat Kurer MA, Stamou KM, Wilson TR, Bradford IM, Leveson SH. Early symptomatic recurrence after intestinal resection in Crohn’s disease is unpredictable. Colorectal Dis 2007;9(6):567–71.PubMedCrossRef Kurer MA, Stamou KM, Wilson TR, Bradford IM, Leveson SH. Early symptomatic recurrence after intestinal resection in Crohn’s disease is unpredictable. Colorectal Dis 2007;9(6):567–71.PubMedCrossRef
36.
Zurück zum Zitat Kane SV, Flicker M, Katz-Nelson F. Tobacco use is associated with accelerated clinical recurrence of Crohn’s disease after surgically induced remission. J Clin Gastroenterol 2005;39(1):32–5.PubMed Kane SV, Flicker M, Katz-Nelson F. Tobacco use is associated with accelerated clinical recurrence of Crohn’s disease after surgically induced remission. J Clin Gastroenterol 2005;39(1):32–5.PubMed
37.
Zurück zum Zitat Reese GE, Nanidis T, Borysiewicz C, Yamamoto T, Orchard T, Tekkis PP. The effect of smoking after surgery for Crohn’s disease: a meta-analysis of observational studies. Int J Colorectal Dis 2008;23(12):1213–21.PubMedCrossRef Reese GE, Nanidis T, Borysiewicz C, Yamamoto T, Orchard T, Tekkis PP. The effect of smoking after surgery for Crohn’s disease: a meta-analysis of observational studies. Int J Colorectal Dis 2008;23(12):1213–21.PubMedCrossRef
38.
Zurück zum Zitat Aldhous MC, Drummond HE, Anderson N, Smith LA, Arnott ID, Satsangi J. Does cigarette smoking influence the phenotype of Crohn’s disease? Analysis using the Montreal classification. Am J Gastroenterol 2007;102(3):577–88.PubMedCrossRef Aldhous MC, Drummond HE, Anderson N, Smith LA, Arnott ID, Satsangi J. Does cigarette smoking influence the phenotype of Crohn’s disease? Analysis using the Montreal classification. Am J Gastroenterol 2007;102(3):577–88.PubMedCrossRef
39.
Zurück zum Zitat Borley NR, Mortensen NJ, Jewell DP. Preventing postoperative recurrence of Crohn’s disease. Br J Surg 1997;84(11):1493–502.PubMedCrossRef Borley NR, Mortensen NJ, Jewell DP. Preventing postoperative recurrence of Crohn’s disease. Br J Surg 1997;84(11):1493–502.PubMedCrossRef
40.
Zurück zum Zitat Bitton A. Preventing postoperative recurrence in Crohn’s disease with 6-mercaptopurine and azathioprine: approaching the cutting edge. Inflamm Bowel Dis 2005;11(5):513–4.PubMedCrossRef Bitton A. Preventing postoperative recurrence in Crohn’s disease with 6-mercaptopurine and azathioprine: approaching the cutting edge. Inflamm Bowel Dis 2005;11(5):513–4.PubMedCrossRef
41.
Zurück zum Zitat Hashemi M, Novell JR, Lewis AA. Side-to-side stapled anastomosis may delay recurrence in Crohn’s disease. Dis Colon Rectum 1998;41(10):1293–6.PubMedCrossRef Hashemi M, Novell JR, Lewis AA. Side-to-side stapled anastomosis may delay recurrence in Crohn’s disease. Dis Colon Rectum 1998;41(10):1293–6.PubMedCrossRef
42.
Zurück zum Zitat Ikeuchi H, Kusunoki M, Yamamura T. Long-term results of stapled and hand-sewn anastomoses in patients with Crohn’s disease. Dig Surg 2000;17(5):493–6.PubMedCrossRef Ikeuchi H, Kusunoki M, Yamamura T. Long-term results of stapled and hand-sewn anastomoses in patients with Crohn’s disease. Dig Surg 2000;17(5):493–6.PubMedCrossRef
43.
Zurück zum Zitat Munoz-Juarez M, Yamamoto T, Wolff BG, Keighley MR. Wide-lumen stapled anastomosis vs. conventional end-to-end anastomosis in the treatment of Crohn’s disease. Dis Colon Rectum 2001;44(1):20–5; discussion 25–6.PubMedCrossRef Munoz-Juarez M, Yamamoto T, Wolff BG, Keighley MR. Wide-lumen stapled anastomosis vs. conventional end-to-end anastomosis in the treatment of Crohn’s disease. Dis Colon Rectum 2001;44(1):20–5; discussion 25–6.PubMedCrossRef
44.
Zurück zum Zitat Scott NA, Sue-Ling HM, Hughes LE. Anastomotic configuration does not affect recurrence of Crohn’s disease after ileocolonic resection. Int J Colorectal Dis 1995;10(2):67–9.PubMedCrossRef Scott NA, Sue-Ling HM, Hughes LE. Anastomotic configuration does not affect recurrence of Crohn’s disease after ileocolonic resection. Int J Colorectal Dis 1995;10(2):67–9.PubMedCrossRef
45.
Zurück zum Zitat D’Haens GR, Vermeire S, Van Assche G, Noman M, Aerden I, Van Olmen G, et al. Therapy of metronidazole with azathioprine to prevent postoperative recurrence of Crohn’s disease: a controlled randomized trial. Gastroenterology 2008;135(4):1123–9.PubMedCrossRef D’Haens GR, Vermeire S, Van Assche G, Noman M, Aerden I, Van Olmen G, et al. Therapy of metronidazole with azathioprine to prevent postoperative recurrence of Crohn’s disease: a controlled randomized trial. Gastroenterology 2008;135(4):1123–9.PubMedCrossRef
46.
Zurück zum Zitat Lochs H, Mayer M, Fleig WE, Mortensen PB, Bauer P, Genser D, et al. Prophylaxis of postoperative relapse in Crohn’s disease with mesalamine: European Cooperative Crohn’s Disease Study VI. Gastroenterology 2000;118(2):264–73.PubMedCrossRef Lochs H, Mayer M, Fleig WE, Mortensen PB, Bauer P, Genser D, et al. Prophylaxis of postoperative relapse in Crohn’s disease with mesalamine: European Cooperative Crohn’s Disease Study VI. Gastroenterology 2000;118(2):264–73.PubMedCrossRef
47.
Zurück zum Zitat Reinisch W, Angelberger S, Petritsch W, Shonova O, Lukas M, Bar-Meir S, et al. Azathioprine versus mesalazine for prevention of postoperative clinical recurrence in patients with Crohn’s disease with endoscopic recurrence: efficacy and safety results of a randomised, double-blind, double-dummy, multicentre trial. Gut;59(6):752–9. Reinisch W, Angelberger S, Petritsch W, Shonova O, Lukas M, Bar-Meir S, et al. Azathioprine versus mesalazine for prevention of postoperative clinical recurrence in patients with Crohn’s disease with endoscopic recurrence: efficacy and safety results of a randomised, double-blind, double-dummy, multicentre trial. Gut;59(6):752–9.
48.
Zurück zum Zitat Cottone M, Mocciaro F, Orlando A. Infliximab prevents Crohn’s disease recurrence after ileal resection. Expert Rev Gastroenterol Hepatol 2009;3(3):231–4.PubMedCrossRef Cottone M, Mocciaro F, Orlando A. Infliximab prevents Crohn’s disease recurrence after ileal resection. Expert Rev Gastroenterol Hepatol 2009;3(3):231–4.PubMedCrossRef
49.
Zurück zum Zitat Regueiro M, Schraut W, Baidoo L, Kip KE, Sepulveda AR, Pesci M, et al. Infliximab prevents Crohn’s disease recurrence after ileal resection. Gastroenterology 2009;136(2):441–50 e1; quiz 716.PubMedCrossRef Regueiro M, Schraut W, Baidoo L, Kip KE, Sepulveda AR, Pesci M, et al. Infliximab prevents Crohn’s disease recurrence after ileal resection. Gastroenterology 2009;136(2):441–50 e1; quiz 716.PubMedCrossRef
50.
Zurück zum Zitat Sorrentino D, Terrosu G, Avellini C, Beltrami CA, Bresadola V, Toso F. Prevention of postoperative recurrence of Crohn’s disease by infliximab. Eur J Gastroenterol Hepatol 2006;18(4):457–9.PubMedCrossRef Sorrentino D, Terrosu G, Avellini C, Beltrami CA, Bresadola V, Toso F. Prevention of postoperative recurrence of Crohn’s disease by infliximab. Eur J Gastroenterol Hepatol 2006;18(4):457–9.PubMedCrossRef
51.
Zurück zum Zitat Yamamoto T, Nakahigashi M, Umegae S, Kitagawa T, Matsumoto K. Impact of long-term enteral nutrition on clinical and endoscopic recurrence after resection for Crohn’s disease: A prospective, non-randomized, parallel, controlled study. Aliment Pharmacol Ther 2007;25(1):67–72.PubMedCrossRef Yamamoto T, Nakahigashi M, Umegae S, Kitagawa T, Matsumoto K. Impact of long-term enteral nutrition on clinical and endoscopic recurrence after resection for Crohn’s disease: A prospective, non-randomized, parallel, controlled study. Aliment Pharmacol Ther 2007;25(1):67–72.PubMedCrossRef
52.
Zurück zum Zitat Blum E, Katz JA. Postoperative therapy for Crohn’s disease. Inflamm Bowel Dis 2009;15(3):463–72.PubMedCrossRef Blum E, Katz JA. Postoperative therapy for Crohn’s disease. Inflamm Bowel Dis 2009;15(3):463–72.PubMedCrossRef
53.
Zurück zum Zitat Colombel JF, Loftus EV, Jr., Tremaine WJ, Pemberton JH, Wolff BG, Young-Fadok T, et al. Early postoperative complications are not increased in patients with Crohn’s disease treated perioperatively with infliximab or immunosuppressive therapy. Am J Gastroenterol 2004;99(5):878–83.PubMedCrossRef Colombel JF, Loftus EV, Jr., Tremaine WJ, Pemberton JH, Wolff BG, Young-Fadok T, et al. Early postoperative complications are not increased in patients with Crohn’s disease treated perioperatively with infliximab or immunosuppressive therapy. Am J Gastroenterol 2004;99(5):878–83.PubMedCrossRef
54.
Zurück zum Zitat Kennedy ED, To T, Steinhart AH, Detsky A, Llewellyn-Thomas HA, McLeod RS. Do patients consider postoperative maintenance therapy for Crohn’s disease worthwhile? Inflamm Bowel Dis 2008;14(2):224–35.PubMedCrossRef Kennedy ED, To T, Steinhart AH, Detsky A, Llewellyn-Thomas HA, McLeod RS. Do patients consider postoperative maintenance therapy for Crohn’s disease worthwhile? Inflamm Bowel Dis 2008;14(2):224–35.PubMedCrossRef
55.
Zurück zum Zitat Olaison G, Smedh K, Sjodahl R. Natural course of Crohn’s disease after ileocolic resection: endoscopically visualised ileal ulcers preceding symptoms. Gut 1992;33(3):331–5.PubMedCrossRef Olaison G, Smedh K, Sjodahl R. Natural course of Crohn’s disease after ileocolic resection: endoscopically visualised ileal ulcers preceding symptoms. Gut 1992;33(3):331–5.PubMedCrossRef
Metadaten
Titel
Frequency and Risk Factors of Postoperative Recurrence of Crohn’s Disease After Intestinal Resection in the Chinese Population
verfasst von
Yi Li
Weiming Zhu
Lugen Zuo
Wei Zhang
Jianfeng Gong
Lili Gu
Lei Cao
Ning Li
Jieshou Li
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 8/2012
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-012-1902-x

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23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

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S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.