Post-surgical recurrence of crohn's disease: situational analysis and future prospects

Valibouze, Caroline; Desreumaux, Pierre; Zerbib, Philippe

Document type :

Article dans une revue scientifique: Article original

DOI :

10.1016/j.jviscsurg.2021.03.012

PMID :

33858790

Permalink :

http://hdl.handle.net/20.500.12210/40475

Title :

Post-surgical recurrence of crohn's disease: situational analysis and future prospects

Author(s) :

Valibouze, Caroline [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Desreumaux, Pierre [Auteur]

Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Zerbib, Philippe [Auteur]

Institute for Translational Research in Inflammation - U 1286 [INFINITE]

Journal title :

Journal of Visceral Surgery

Abbreviated title :

J Visc Surg

Volume number :

158

Pages :

401-410

Publication date :

2021-10

ISSN :

1878-7886

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Surgery retains a major role in the treatment of Crohn's disease, and the prevention of post-operative recurrence is an essential issue. In fact, despite the increasing use of biotherapies, almost all of the patients who ...
Show more >Surgery retains a major role in the treatment of Crohn's disease, and the prevention of post-operative recurrence is an essential issue. In fact, despite the increasing use of biotherapies, almost all of the patients who undergo surgery will present with a recurrence, initially endoscopic and then clinical, eventually leading to a second intervention in 15 to 20% of cases. Certain risk factors for recurrence such as smoking, repeated and/or extensive resections, anoperineal involvement, myenteric plexitis, epithelioid granulomas, penetrating disease behaviour and lack of post-operative prophylactic treatment have been well established. Currently, measures to prevent post-operative recurrence are based mainly on smoking cessation in all patients and the prescription of anti-TNFα medications for patients with a high risk of recurrence (at least two risk factors for recurrence). However, new surgical techniques have recently been described which could modify post-operative prevention strategies. Kono's lateral anti-mesenteric anastomosis could significantly reduce clinical and endoscopic recurrence compared to conventional anastomosis techniques. Long latero-lateral isoperistaltic stricturoplasties have been shown to be feasible and are associated with a low rate of long-term symptomatic recurrence requiring surgery. In a preliminary series, intestinal resections with extensive mesenteric resection reduced the rate of recurrence in comparison with patients operated on conventionally (3% vs. 40% at five years). If the results of these new surgical techniques are confirmed, the indications for post-operative immunomodulatory treatments could be downgraded in patients currently considered to be at high risk of recurrence.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

Submission date :

2021-07-06T12:44:27Z
2024-01-10T12:54:33Z

Version	Link	Modification date
2	20.500.12210/40475*	2024-01-10T12:50:44Z
1	20.500.12210/40475.1	2021-07-06T12:44:27Z

Post-surgical recurrence of crohn's disease: ...

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Post-surgical recurrence of crohn's disease: ...

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