Title :

Post-operative recurrence of crohn's disease after definitive stoma: an underestimated risk

Author(s) :

Koriche, Dine [Auteur]
Gower, Corinne [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Chater, Charbel [Auteur]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Salleron, Julia [Auteur]
Tavernier, Noemie [Auteur]
Colombel, Jean-Frédéric [Auteur]
Pariente, Benjamin [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Cortot, Antoine [Auteur]
Zerbib, Philippe [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]

Journal title :

International journal of colorectal disease

Abbreviated title :

Int. J. Colorectal Dis.

Volume number :

32

Pages :

453-458

Publication date :

2017-04-01

ISSN :

0179-1958

English keyword(s) :

Crohn''s disease
Colostomy
Definitive stoma

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Crohn's disease (CD) is a progressive inflammatory disease affecting the entire gastrointestinal tract. The need for a definitive stoma (DS) is considered as the ultimate phase of damage. It is often believed ...
Show more >BACKGROUND: Crohn's disease (CD) is a progressive inflammatory disease affecting the entire gastrointestinal tract. The need for a definitive stoma (DS) is considered as the ultimate phase of damage. It is often believed that the risk of further disease progression is small when a DS has been performed. OBJECTIVE: The goals of the study were to establish the rate of CD recurrence above the DS and to identify predictive factors of CD recurrence at the time of DS. METHODS: We retrospectively reviewed all medical records of consecutive CD patients having undergone DS between 1973 and 2010. We collected clinical data at diagnosis, CD phenotype, treatment, and surgery after DS and mortality. Stoma was considered as definitive when restoration of continuity was not possible due to proctectomy, rectitis, anoperineal lesions (APL), or fecal incontinence. Clinical recurrence (CR) was defined as the need for re-introduction or intensification of medical therapy, and surgical recurrence (SR) was defined as a need for a new intestinal resection. RESULTS: Eighty-three patients (20 males, 63 females) with a median age of 34 years at CD diagnosis were included. The median time between diagnosis and DS was 9 years. The median follow-up after DS was 10 years. Thirty-five patients (42%) presented a CR after a median time of 28 months (2-211) and 32 patients (38%) presented a SR after a median time of 29 months (4-212). In a multivariate analysis, APL (HR = 5.1 (1.2-21.1), p = 0.03) and colostomy at time of DS (HR = 3.8 (1.9-7.3), p = 0.0001) were associated factors with the CR. CONCLUSIONS: After DS for CD, the risk of clinical recurrence was high and synonymous with surgical recurrence, especially for patients with APL and colostomy.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2020-02-11T09:07:28Z
2021-06-02T08:42:48Z