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Prevention of Postoperative Recurrence in CD: Tailoring Treatment to Patient Profile

[ Vol. 20 , Issue. 13 ]

Author(s):

Marjorie Argollo, Paulo Gustavo Kotze, Laura Lamonaca, Daniela Gilardi, Federica Furfaro, Takayuki Yamamoto and Silvio Danese*   Pages 1327 - 1338 ( 12 )

Abstract:


Crohn’s disease (CD) is an immune-mediated condition characterized by the transmural inflammation of the gut tissue, associated with progressive bowel damage often leading to surgical intervention. As operative resection of the damaged segment is not curative, a majority of patients undergoing intestinal resections for complicated CD present disease recurrence within 3 years after the intervention. Postoperative recurrence can be defined as endoscopic, clinical, radiological or surgical. Endoscopic recurrence rates within 1 year exceed 60% and the severity, according to the Rutgeerts’ score, is associated with worse prognosis and can predict clinical recurrence (in up to 1/3 of the patients). Most importantly, about 50% of patients will undergo a reoperation after 10 years of their first intestinal resection. Therefore, the prevention of postoperative recurrence in CD remains a challenge in clinical practice and should be properly managed. We aim to summarize the most recent data on the definition, risk factors, assessment and treatment of postoperative CD recurrence.

Keywords:

Crohn's disease, postoperative recurrence, prevention, surgery treatment, immune-mediated, transmural inflammation.

Affiliation:

IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Institute, Milan, IBD outpatient clinics, Catholic University of Parana (PUCPR), Curitiba, IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Institute, Milan, IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Institute, Milan, IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Institute, Milan, Department of Surgery and IBD Centre, Yokkaichi Hazu Medical Centre, Yokkaichi, IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Institute, Milan

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