Post-Operative Recurrence of Colonic Crohn's Disease After Colectomy: The RESECOL Study by the Young Group of GETECCU.
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.
Rueda García J L, Suárez Ferrer C, García de la Filia Molina I, Rivas C, Fernández-Clotet A, Céspedes Martínez E, Martínez Cuevas C, Balderramo D C, Arias L, Martínez Lozano H, Vaamonde Lorenzo M, Calafat M, Martín Rodríguez D, Segarra Ortega J X, Gisbert J P, Brunet-Mas E, González-Partida I, Cerrillo Bataller E, Varela Trastoy P, Auquilla Pauta K, Igualada Escribano L, Marquès-Camí M, Muñoz Villafranca C, de Francisco García R M, Elosua González A, Bastón-Rey I, Martínez-Cadilla J, Pardeiro Mariño L, Belén-Galipienso O, Vázquez García P, Latre M, Sendra Rumbeu P, Altadill Mauri A, López-Martín M C, Ponferrada-Díaz Á, Arribas López M R, Rodríguez-Sánchez S, Wolfe García P M, Ruiz-Ramírez M A, Moralejo Lozano O, Sanz Segura P, Madrigal Bayonas L, Huguet J M, Torres G, Alonso Abreu I, Martín-Arranz M D, Mañosa Ciria M, Zabana Y, Young Group of GETECCU (Spanish Working Group on Crohn's Disease and Ulcerative Colitis)
Аннотация
METHODS: Multicentre, nationwide, retrospective study including colonic CD patients undergoing SC or STC. Clinical, endoscopic, radiologic and surgical POR were assessed and POR-free survival was compared between procedures. Cox regression determined predictors of post-colectomy POR. Inverse probability of treatment weighting (IPTW) was carried out for sensitivity analyses.
RESULTS: A total of 224 patients were included (157 SC, 67 STC). Clinical POR occurred less frequently after SC than after STC (38% vs 63%, p = 0.001), as did endoscopic POR (50% vs 71%, p = 0.012); whereas radiologic and surgical POR rates were similar (p = 0.1 and p = 0.992, respectively). Clinical POR-free survival at 1 and 5 years was higher after SC than after STC (82% and 64.8% vs 67.6% and 39%, log-rank p = 0.001). Endoscopic POR-free survival followed a similar pattern (log-rank p < 0.001). In multivariable Cox regression, SC remained protective against clinical (HR 0.54 [0.36-0.81]) and early endoscopic POR (HR 0.54 [0.35-0.82]). After IPTW, SC was still associated with a significantly lower risk of clinical and endoscopic POR.
CONCLUSION: Clinical and endoscopic POR rates are significantly lower following SC compared with STC in colonic CD, while radiologic and surgical recurrence rates were similar. SC shows a protective effect regarding clinical and early endoscopic POR. These data support segmental resection of colonic CD when feasible.