Redo ileocolic resection in Crohn's disease - does time passed since previous surgery matter?


Journal

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611

Informations de publication

Date de publication:
04 2022
Historique:
revised: 15 10 2021
received: 23 06 2021
accepted: 20 12 2021
pubmed: 28 12 2021
medline: 4 5 2022
entrez: 27 12 2021
Statut: ppublish

Résumé

Surgical resection for Crohn's disease (CD) remains noncurative, therefore recurrence is a significant problem. Although numerous factors affecting surgical outcomes in redo ileocolic resection have been previously described, no study has considered the relation between the interval of time from initial ileocolic resection to the redo procedure and its effect on surgical outcomes. The aim of this study was to explore this relationship. A retrospective review of all adult patients undergoing redo ileocolic resection for CD between 2011 to 2020 was conducted. Patients were divided into two groups based on time from initial ileocolic resection. Patients operated within 10 years of their initial surgery (≤10 years) were assigned to the early group, while patients operated >10 years after initial surgery were allocated to the late group. Primary outcome was the 30-day postoperative major complication rate. Fifty-eight patients underwent redo ileocolic resection, 24 in the early group and 34 in the late group. Apart from older median age in the late group (56 vs. 46.5 years, p = 0.026), the groups were similar for patient factors, disease site and behaviour, use of immune-suppressing medication and procedural factors. Significant differences in 30-day postoperative morbidity included longer length of stay (6 vs. 5 days, p = 0.035), a higher major complication rate (23.5% vs. 4.1%, p = 0.04) and higher readmission rate (26.4% vs. 4.1%, p = 0.035) in the late group. The overall complication rate remained nonsignificant (37.5% vs. 61.8%, p = 0.1). Redo ileocolic resection, when performed >10 years from the initial ileocolic resection, may be associated with increased morbidity, specifically higher rates of major postoperative complications, a longer length of stay and more readmissions.

Identifiants

pubmed: 34958523
doi: 10.1111/codi.16035
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

484-490

Informations de copyright

© 2021 The Association of Coloproctology of Great Britain and Ireland.

Références

Olaison G, Smedh K, Sjödahl R. Natural course of Crohn’s disease after ileocolic resection: endoscopically visualised ileal ulcers preceding symptoms. Gut. 1992;33:331-5.
Rutgeerts P, Geboes K, Vantrappen G, Kerremans R, Coenegrachts JL, Coremans G. Natural history of recurrent Crohns disease at the ileocolonic anastomosis after curative surgery. Gut. 1984;25:665-72.
Rutgeerts P, Geboes K, Vantrappen G, Beyls J, Kerremans R, Hiele M. Predictability of the postoperative course of Crohn’s disease. Gastroenterology. 1990;99:956-63.
de Buck van Overstraeten A, Eshuis EJ, Vermeire S, Van Assche G, Ferrante M, D'Haens GR, et al. Short- and medium-term outcomes following primary ileocaecal resection for Crohn’s disease in two specialist centres. Br J Surg. 2017;104:1713-22.
McKenna NP, Habermann EB, Glasgow AE, Dozois EJ, Lightner AL. Intra-abdominal sepsis after ileocolic resection in Crohn’s disease: the role of combination immunosuppression. Dis Colon Rectum. 2018;61 (12):1393-402.
Neary PM, Aiello AC, Stocchi L, Shawki S, Hull T, Steele SR, et al. High-risk ileocolic anastomoses for Crohn’s disease: when is diversion indicated? J Crohn’s Colitis, 2019;13(7):856-63.
Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR, et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol, 2005;Suppl A:5A-36A.
Crohn BB, Ginzburg L, Oppenheimer GD. Regional ileitis: a pathologic and clinical entity. JAMA. 1932;99:1323-9.
Buisson A, Chevaux JB, Allen PB, Bommelaer G, Peyrin-Biroulet L. Review article: the natural history of postoperative Crohn’s disease recurrence. Aliment Pharmacol Ther. 2012;35:625-33.
Johnston WF, Stafford C, Francone TD, Read TE, Marcello PW, Roberts PL, et al. What is the risk of anastomotic leak after repeat intestinal resection in patients with Crohn’s disease? Dis Colon Rectum. 2017;60:1299-306.
Michelassi F, Balestracci T, Chappell R, Block GE. Primary and recurrent Crohn's disease. Ann Surg. 1991;214:230-8; discussion 238-40.
Kim NK, Senagore AJ, Luchtefeld MA, MacKeigan JM, Mazier WP, Belknap K, et al. Long-term outcome after ileocecal resection for Crohn's disease. Am Surg. 1997;63:627-33.
Andrews HA, Lewis P, Allan RN. Prognosis after surgery for colonic Crohn's disease. Br J Surg. 1989;76:1184-90.
Penner RM, Madsen KL, Fedorak RN. Postoperative Crohn's disease. Inflamm Bowel Dis. 2005;11:765-77.
Carmichael H, Peyser D, Baratta VM, Bhasin D, Dean A, Khaitov S, et al. The role of laparoscopic surgery in repeat ileocolic resection for Crohn’s disease. Colorectal Dis. 2021;23(8):2075-84.
Stevens TW, Haasnoot ML, D’Haens GR, Buskens CJ, de Groof EJ, Eshuis EJ, et al. Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn’s disease: retrospective long-term follow-up of the LIR!C trial. Lancet Gastroenterol Hepatol. 2020;5:900-7.
Ponsioen CY, de Groof EJ, Eshuis EJ, Gardenbroek TJ, Bossuyt PMM, Hart A, et al. Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn's disease: a randomised controlled, open-label, multicentre trial. Lancet Gastroenterol Hepatol. 2017;2:785-92.
Golovics PA, Mandel MD, Lovasz BD, Lakatos PL. Inflammatory bowel disease course in Crohn’s disease: is the natural history changing? World J Gastroenterol. 2014;20:3198.

Auteurs

Michael R Freund (MR)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA.

Ilan Kent (I)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA.

Nir Horesh (N)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA.

Timothy Smith (T)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA.

Steven D Wexner (SD)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA.

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