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Analysis of risk factors - especially different types of plexitis - for postoperative relapse in Crohn's disease

  • Metaadatok
Tartalom: http://real.mtak.hu/63999/
Archívum: MTA Könyvtár
Gyűjtemény: Status = Published


Type = Article
Cím:
Analysis of risk factors - especially different types of plexitis - for postoperative relapse in Crohn's disease
Létrehozó:
Milassin, Ágnes
Sejben, Anita
Tiszlavicz, LĂĄszlĂł
Reisz, Zita
LĂĄzĂĄr, GyĂśrgy ifj
SzĹącs, MĂłnika
Bor, RenĂĄta
BĂĄlint, Anita
Rutka, Mariann
Szepes, ZoltĂĄn
Nagy, Ferenc
Farkas, Klaudia
MolnĂĄr, TamĂĄs
Kiadó:
Baishideng Publishing Group Inc
Dátum:
2017
Téma:
RC Internal medicine / belgyĂłgyĂĄszat
RD Surgery / sebĂŠszet
Tartalmi leírás:
AIM: To evaluate the presence of submucosal and myenteric plexitis and its role in predicting postoperative recurrence. METHODS: Data from all patients who underwent Crohn's disease (CD)-related resection at the University of Szeged, Hungary between 2004 and 2014 were analyzed retrospectively. Demographic data, smoking habits, previous resection, treatment before and after surgery, resection margins, neural fiber hyperplasia, submucosal and myenteric plexitis were evaluated as possible predictors of postoperative recurrence. Histological samples were analyzed blinded to the postoperative outcome and the clinical history of the patient. Plexitis was evaluated based on the appearance of the most severely inflamed ganglion or nerve bundle. Patients underwent regular follow-up with colonoscopy after surgery. Postoperative recurrence was defined on the basis of endoscopic and clinical findings, and/or the need for additional surgical resection. RESULTS: One hundred and four patients were enrolled in the study. Ileocecal, colonic, and small bowel resection were performed in 73.1%, 22.1% and 4.8% of the cases, respectively. Mean disease duration at the time of surgery was 6.25 years. Twenty-six patients underwent previous CD-related surgery. Forty-three point two percent of the patients were on 5-aminosalicylate, 20% on corticosteroid, 68.3% on immunomodulant, and 4% on anti-tumor necrosis factor-alpha postoperative treatment. Postoperative recurrence occurred in 61.5% of the patients; of them 39.1% had surgical recurrence. 92.2% of the recurrences developed within the first five years after the index surgery. Mean disease duration for endoscopic relapse was 2.19 years. The severity of submucosal plexitis was a predictor of the need for second surgery (OR = 1.267, 95%CI: 1.000-1.606, P = 0.050). Female gender (OR = 2.21, 95%CI: 0.98-5.00, P = 0.056), stricturing disease behavior (OR = 3.584, 95%CI: 1.344-9.559, P = 0.011), and isolated ileal localization (OR = 2.671, 95%CI: 1.033-6.910, P = 0.043) were also predictors of postoperative recurrence. No association was revealed between postoperative recurrence and smoking status, postoperative prophylactic treatment and the presence of myenteric plexitis and relapse. CONCLUSION: The presence of severe submucosal plexitis with lymphocytes in the proximal resection margin is more likely to result in postoperative relapse in CD.
Nyelv:
angol
Típus:
Article
PeerReviewed
info:eu-repo/semantics/article
Formátum:
text
Azonosító:
Milassin, Ágnes and Sejben, Anita and Tiszlavicz, Låszló and Reisz, Zita and Låzår, GyÜrgy ifj and SzŹcs, Mónika and Bor, Renåta and Bålint, Anita and Rutka, Mariann and Szepes, Zoltån and Nagy, Ferenc and Farkas, Klaudia and Molnår, Tamås (2017) Analysis of risk factors - especially different types of plexitis - for postoperative relapse in Crohn's disease. WORLD JOURNAL OF GASTROINTESTINAL SURGERY, 9 (7). pp. 167-173. ISSN 1948-9366
Kapcsolat:
https://doi.org/10.4240/wjgs.v9.i7.167
MTMT:3257117; doi:10.4240/wjgs.v9.i7.167