Long-term comparative outcomes after ileocecal resection for inflammatory versus complicated Crohn's disease. A multicenter, retrospective study (Crohn's-Urg).
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Avellaneda Nicolas, Maroli Annalisa, Pellino Gianluca, Carvello Michele, Tottrup Anders, Bislenghi Gabriele, Colpaert Jan, D'Hoore Andre, Giorgi Lorenzo, Juachon Patrizia, Harsløf Sanne, Van Overstraeten Anthony de Buck, Olivera Pablo A, Gomez Javier, Holubar Stefan D, Naranjo Eddy Lincango, Steele Scott R, Merchea Amit, Shaker Andrew, Martí-Gallostra Marc, Kraft Miquel, Kotze Paulo Gustavo, Araujo Rafaela Molteni Moretti, Wexner Steven D, Garoufalia Zoe, Chen Zhihui, Hahnloser Dieter, Rrupa Djana, Buskens Christianne, Haanappel Anouck, Warusavitarne Janindra, Williams Katherine J, Christensen Peter, Wolthuis Albert, Lasa Juan, Armuzzi Alessandro, Spinelli Antonino
Аннотация
METHODS: This international, multicenter, retrospective cohort study evaluated long-term outcomes of ICR in patients with inflammatory (uncomplicated) and complicated CD phenotypes. Data from 2013 patients (291 with uncomplicated CD) who underwent surgery between 2012 and 2022 were analyzed. The primary endpoint was endoscopic disease recurrence, with secondary outcomes including clinical and surgical recurrence, fecal calprotectin levels, and risk factors for recurrence. Statistical analyses included Kaplan-Meier survival estimates, Cox regression, and multivariable modeling.
RESULTS: Complicated CD patients had higher rates of preoperative anemia, emergent surgery, and open procedures. Despite these differences, long-term endoscopic (HR: 1.03; p = 0.748), clinical (HR: 1.35; p = 0.073), and surgical recurrence rates (HR: 0.77; p = 0.419) were comparable between groups. Protective factors for recurrence included laparoscopic surgery (HR: 0.74; p = 0.009) and postoperative prophylaxis (HR: 0.63; p < 0.0001), while preoperative anemia (HR: 1.52; p < 0.0001) and positive margins (HR: 1.36; p = 0.001) increased recurrence risk.
CONCLUSION: Long-term outcomes of ICR are similar in inflammatory and complicated CD when appropriate surgical and medical management is applied. Optimizing perioperative care and mitigating modifiable risk factors may improve outcomes, supporting the role of surgery even in less complicated CD cases.