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Penetrating Crohn Disease Is Not Associated With a Higher Risk of Recurrence After Surgery

hal.structure.identifierHôpital Beaujon
dc.contributor.authorMAGGIORI, Léon
hal.structure.identifierHôpital Bicêtre
dc.contributor.authorBROUQUET, Antoine
hal.structure.identifierCentre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
dc.contributor.authorZERBIB, Philippe
hal.structure.identifierInstitut Charles Gerhardt Montpellier - Institut de Chimie Moléculaire et des Matériaux de Montpellier [ICGM ICMMM]
hal.structure.identifierCEREST-TC [CHU Saint-Antoine]
dc.contributor.authorLEFÊVRE, Jérémie
hal.structure.identifierBioingénierie tissulaire [BIOTIS]
hal.structure.identifierCHU Bordeaux
dc.contributor.authorDENOST, Quentin
hal.structure.identifierCentre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
dc.contributor.authorGERMAIN, Adeline
hal.structure.identifierCentre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
dc.contributor.authorCOTTE, Eddy
hal.structure.identifierCHU Marseille
dc.contributor.authorBEYER-BERJOT, Laura
hal.structure.identifierHopital Saint-Louis [AP-HP] [AP-HP]
dc.contributor.authorMUNOZ-BONGRAND, Nicolas
hal.structure.identifierCentre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
dc.contributor.authorDESFOURNEAUX, Véronique
hal.structure.identifierCentre Hospitalier Universitaire de Nice [CHU Nice]
dc.contributor.authorRAHILI, Amine
hal.structure.identifierChirurgie Générale et Digestive [Rangueil]
dc.contributor.authorDUFFAS, Jean-Pierre
hal.structure.identifierHôpital Lariboisière-Fernand-Widal [APHP]
dc.contributor.authorPAUTRAT, Karine
hal.structure.identifierHôpital Lariboisière
hal.structure.identifierInstitut Mutualiste de Montsouris [IMM]
dc.contributor.authorDENET, Christine
hal.structure.identifierService de Chirurgie Digestive [CHU Rouen]
dc.contributor.authorBRIDOUX, Valérie
hal.structure.identifierCentre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
dc.contributor.authorMEURETTE, Guillaume
hal.structure.identifierCentre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
dc.contributor.authorFAUCHERON, Jean-Luc
hal.structure.identifierCentre hospitalier Saint-Joseph [Paris]
dc.contributor.authorLORIAU, Jérôme
hal.structure.identifierCentre Hospitalier Régional Universitaire [Montpellier] [CHRU Montpellier]
dc.contributor.authorSOUCHE, Regis
hal.structure.identifierGroupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris]
dc.contributor.authorVICAUT, Eric
hal.structure.identifierHôpital Beaujon
dc.contributor.authorPANIS, Yves
hal.structure.identifierHôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
dc.contributor.authorBENOIST, Stéphane
dc.date.accessioned2021-06-10T07:04:32Z
dc.date.available2021-06-10T07:04:32Z
dc.date.issued2019
dc.identifier.issn0003-4932
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/78981
dc.description.abstractEnOBJECTIVE:The aim of this study was to assess recurrence risk factors following ileocolonic resection (ICR) for Crohn disease (CD) in a nationwide cohort study SUMMARY BACKGROUND DATA:: Recurrence rate after ICR for CD can be up to 60%, but its predictive factors have never been evaluated in large prospective cohort studies.METHODS:From 2013 to 2015, 346 consecutive patients undergoing ICR for CD and a postoperative ileocoloscopy within 6 to 12 months after surgery at 19 academic French centers were included prospectively.RESULTS:Twelve-month postoperative endoscopic (Rutgeerts score ≥i2) and clinical recurrence rates were 57.6% [95% confidence interval (CI), 54.2-61.0] and 11.3% (95% CI, 9-13.6), respectively. A total of 185 patients (54%) had a postoperative CD prophylaxis, comprising thiopurine in 69 (20%), or anti-tumor necrosis factor (TNF) therapy in 93 (27%). In multivariate Cox regression analysis, absence of postoperative smoking {odds ratio [OR] = 0.60 (95% CI, 0.40-0.91); P = 0.016}, postoperative prophylaxis [OR = 0.60 (95% CI, 0.41-0.88); P = 0.009], and penetrating disease behavior [OR = 0.58 (95% CI, 0.39-0.86); P = 0.007] were the only independent predictors of reduced endoscopic recurrence risk. Postoperative prophylaxis [OR 0.31 (95% CI, 0.15-0.66); P = 0.002), and penetrating behavior [OR = 00.36 (95% CI, 0.16-0.81); P = 0.013), were the only independent predictors of reduced clinical recurrence risk. Postoperative anti-TNF therapy was associated with a significant reduction of both 12-month risks of endoscopic (P < 0.001) and clinical (P = 0.019) recurrences.CONCLUSION:Absence of postoperative smoking, CD prophylaxis, and penetrating disease behavior could be independent predictors of reduced postoperative recurrence after ICR for CD. Prophylactic anti-TNF therapy reduces both endoscopic and clinical recurrence rates. It suggests that upfront surgery followed by postoperative anti-TNF therapy is probably the best therapeutic approach for complex CD (penetrating disease behavior).
dc.language.isoen
dc.publisherLippincott, Williams & Wilkins
dc.subject.meshColon/surgery; Crohn Disease/surgery; Crohn Disease/diagnosis; Digestive System Surgical Procedures/methods; Ileum/surgery; Intestinal Perforation/surgery
dc.title.enPenetrating Crohn Disease Is Not Associated With a Higher Risk of Recurrence After Surgery
dc.typeArticle de revue
dc.identifier.doi10.1097/SLA.0000000000003531
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologie
bordeaux.journalAnnals of Surgery
bordeaux.page827-834
bordeaux.volume270
bordeaux.hal.laboratoriesBioingénierie Tissulaire (BioTis) - U1026*
bordeaux.issue5
bordeaux.institutionCNRS
bordeaux.institutionINSERM
bordeaux.institutionCHU de Bordeaux
bordeaux.institutionInstitut Bergonié
bordeaux.peerReviewedoui
hal.identifierhal-02558225
hal.version1
hal.origin.linkhttps://hal.archives-ouvertes.fr//hal-02558225v1
bordeaux.COinSctx_ver=Z39.88-2004&amp;rft_val_fmt=info:ofi/fmt:kev:mtx:journal&amp;rft.jtitle=Annals%20of%20Surgery&amp;rft.date=2019&amp;rft.volume=270&amp;rft.issue=5&amp;rft.spage=827-834&amp;rft.epage=827-834&amp;rft.eissn=0003-4932&amp;rft.issn=0003-4932&amp;rft.au=MAGGIORI,%20L%C3%A9on&amp;BROUQUET,%20Antoine&amp;ZERBIB,%20Philippe&amp;LEF%C3%8AVRE,%20J%C3%A9r%C3%A9mie&amp;DENOST,%20Quentin&amp;rft.genre=article


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