Risk factors for postoperative recurrence of Crohn's disease with emphasis on surgical predictors

 
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Annals of Gastroenterology
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Σημασιολογικός εμπλουτισμός από το EKT
Τμήμα περιοδικού (EL)
Επιστημονικό άρθρο (EL)
Βιβλιοκρισία / Βιβλιοπαρουσίαση (EL)
2017 (EL)
Risk factors for postoperative recurrence of Crohn's disease with emphasis on surgical predictors (EN)
Gklavas, Antonios
Papaconstantinou, Ioannis
Dellaportas, Dionysios
Intestinal resection for Crohn's disease is not curative and postoperative recurrence rates remain high. Early detection of indices associated with recurrence and risk stratification are fundamental for the postoperative management of patients. Early endoscopy at 6-12 months is the "gold standard" procedure, whereas other modalities such as fecal calprotectin and imaging techniques can contribute to the diagnosis of recurrence. The purpose of this review is to summarize current data regarding risk factors correlated with postoperative relapse. Smoking is a well-established, modifiable risk factor. There are sufficient data that correlate penetrating disease, perianal involvement, extensive resections, prior surgery, histological features (plexitis and granulomas), and improper management after resection with high rates for recurrence. The literature provides conflicting data for other possible predictors, such as age, sex, family history of inflammatory bowel disease, location of disease, strictureplasties, blood transfusions, and postoperative complications, necessitating further evidence. On the other hand, surgical factors such as anastomotic configuration, open or laparoscopic approach, and microscopic disease at specimen margins when macroscopic disease is resected, seem not to be related with an increased risk of recurrence. Further recognition of histological features as well as gene-related factors are promising fields for research.Keywords Crohn's disease, recurrence risk factors, postoperative recurrenceAnn Gastroenterol 2017; 30 (6): 598-612 (EN)
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Ελληνική Γαστροεντερολογική Εταιρία
Annals of Gastroenterology
Review Articles
Αγγλική γλώσσα
2017-11-02
http://www.annalsgastro.gr/index.php/annalsgastro/article/view/3430
Hellenic Society of Gastroenterology (EN)
1792-7463
1108-7471
Annals of Gastroenterology; Volume 30, No 6 (2017); 598 (EN)



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