Abstract:
OBJECTIVE:Ileocaecal resection is the most common operation performed in Crohn's disease. Our study aimed to identify the risk factors for anastomotic recurrence following primary ileocaecal resection. PATIENTS AND METHODS:We retrospectively analysed data from all Crohn's disease surgical patients in a single colorectal unit between 2006 and 2016, including all patients who underwent primary ileocaecal resection. We defined anastomotic recurrence as the postoperative need for endoscopic dilatation of the ileocolic anastomosis or neoterminal ileal resection, and used Cox regression to determine the risk factors for such recurrence. RESULTS:In total, 101 patients underwent primary ileocaecal resection during the study period. Nine (8.9%) patients were excluded because of follow-up less than 1 year and 12 (13.0%) patients had anastomotic recurrence. The median follow-up was 4.7 (1.3-10.8) years. At 3 years, 93.1% of patients required no neoterminal ileal resection or dilatation of the ileocolic anastomosis. Urgent primary ileocaecal resection [hazard ratio (HR)=4.98, 95% confidence interval (CI)=1.45-17.11, P=0.011], stapled anastomosis (HR=20.34, 95% CI=5.06-81.77, P<0.001) and need for postoperative corticosteroid treatment after the primary ileocaecal resection (HR=3.58, 95% CI=1.03-12.40, P=0.044) emerged as significant risk factors for anastomotic recurrence. CONCLUSION:Urgent surgery and postoperative corticosteroid need represented risk factors for anastomotic recurrence. Hand-sewn anastomosis with an opening of the bowel's antimesenteric border seems to be a safe choice for ileocaecal resection.
journal_name
Eur J Gastroenterol Hepatoljournal_title
European journal of gastroenterology & hepatologyauthors
Aaltonen G,Keränen I,Carpelan-Holmström M,Lepistö Adoi
10.1097/MEG.0000000000001206subject
Has Abstractpub_date
2018-10-01 00:00:00pages
1143-1147issue
10eissn
0954-691Xissn
1473-5687journal_volume
30pub_type
杂志文章abstract:OBJECTIVES:Cells infected with the hepatitis B or C virus can be eliminated by an immune response mediated by cytotoxic T cells. Recently, the Fas Ligand has been detected on the surface of cytotoxic T cells, and is thought to induce cells to apoptosis by adhering to the Fas antigen. METHODS:To evaluate the role of th...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-200403000-00015
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journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:10.1097/00042737-200502000-00013
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更新日期:2012-07-01 00:00:00
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journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章,meta分析
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2017-06-01 00:00:00
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更新日期:2000-04-01 00:00:00
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journal_title:European journal of gastroenterology & hepatology
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更新日期:1997-01-01 00:00:00
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