Title :

Risk factors for surgery in stricturing small bowel Crohn's disease: A retrospective cohort study from the GETAID pédiatrique.

Author(s) :

Lacotte, E. [Auteur]
Université de Caen Normandie [UNICAEN]
Boujonnier, L. [Auteur]
Université de Caen Normandie - UFR Santé [UNICAEN Santé]
Martinez-Vinson, C. [Auteur]
Hôpital Robert Debré
Viala, J. [Auteur]
Hôpital Robert Debré
Ley, Delphine [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Coopman, S. [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lerisson, H. [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Dabadie, A. [Auteur]
Centre Hospitalier Universitaire [Rennes]
Dumant-Forrest, C. [Auteur]
CHU Rouen
Pigneur, B. [Auteur]
Ruemmele, F. [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]
Enaud, R. [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Comte, A. [Auteur]
Centre Hospitalier Régional Universitaire de Besançon [CHRU Besançon]
Rebeuh, J. [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Bertrand, V. [Auteur]
Groupe Hospitalier du Havre
Caron, N. [Auteur]
Service Urgences Pédiatriques et UHCD [CHU Clermont-Ferrand]
Breton, A. [Auteur]
Pôle Maladies de l'appareil digestif [CHU Toulouse]
Duclaux-Loras, R. [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Vasies, I. [Auteur]
CHU Rouen
Dupont-Lucas, C. [Auteur]
CHU Caen

Journal title :

J Pediatr Gastroenterol Nutr

Abbreviated title :

J Pediatr Gastroenterol Nutr

Publication date :

2024-04-28

ISSN :

1536-4801

English keyword(s) :

inflammatory bowel disease
magnetic resonance imaging
pediatrics

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Abstract Objectives Previous studies have shown rates of surgical resection of up to 41% in stricturing pediatric Crohn's disease. In this retrospective multicenter study, our aims were to identify clinical risk factors ...
Show more >Abstract Objectives Previous studies have shown rates of surgical resection of up to 41% in stricturing pediatric Crohn's disease. In this retrospective multicenter study, our aims were to identify clinical risk factors and magnetic resonance enterography (MRE) features of small bowel strictures associated with surgery. Methods Pediatric patients with symptomatic stricturing small bowel CD (defined as obstructive symptoms or proximal dilatation on MRE) confirmed by MRE between 2010 and 2020 were recruited from 12 French tertiary hospitals. Patient characteristics were compared by surgical outcome multivariable Cox regression. Results Fifty‐six patients (61% boys) aged 12.2 ± 2.7 years at diagnosis of CD were included. Median duration of CD before diagnosis of stricture was 11.7 months (interquartile range [IQR]: 25–75: 1.2–29.9). Nineteen (34%) patients had stricturing phenotype (B2) at baseline. Treatments received before stricture diagnosis included MODULEN‐IBD ( n = 31), corticosteroids ( n = 35), antibiotics ( n = 10), anti‐TNF ( n = 27), immunosuppressants ( n = 28). Thirty‐six patients (64%) required surgery, within 4.8 months (IQR: 25–75: 1.8–17.3) after stricture diagnosis. Parameters associated with surgical resection were antibiotic exposure before stricture diagnosis (adjusted odds ratio [aOR]: 15.62 [3.35–72.73], p = 0.0005), Crohn's disease obstructive symptoms score (CDOS) > 4 (aOR: 3.04 [1.15–8.03], p = 0.02) and dilation proximal to stricture >28 mm (aOR: 3.62 [1.17–11.20], p = 0.03). Conclusion In this study, antibiotic treatment before stricture diagnosis, intensity of obstructive symptoms, and diameter of dilation proximal to small bowel stricture on MRE were associated with risk for surgical resection.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-05-15T21:23:26Z
2024-08-28T08:31:47Z