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Crohns disease surgery

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https://www.readbyqxmd.com/read/28098059/laparoscopic-ileocecal-resection-in-acute-and-chronic-presentations-of-crohn-s-disease-a-single-center-experience
#1
G Cocorullo, R Tutino, N Falco, G Salamone, T Fontana, L Licari, G Gulotta
INTRODUCTION: The terminal ileum is the most involved tract in Crohn's disease. The obstruction in this location is the most frequent complication. Acute or chronic presentations can occur. Surgery finds a role in the management of chronic strictures and in acute clinical presentations with complications not improving with conservative therapy. PATIENTS AND METHODS: We investigate the outcome of patients with obstruction of the ileo-cecal bowel tract laparoscopically managed...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28087973/granulomas-in-mesenteric-lymph-nodes-in-crohn-s-disease-patients-with-ileocolic-resection-are-areassociated-with-younger-age-and-transmural-inflammation
#2
Xingwen Sun, Lisi Yuan, Yi Li, Bo Shen, Hao Xie, Xiuli Liu
BACKGROUND & AIMS: Mesenteric lymph nodes were usually removed during bowel resection surgery for Crohn's disease (CD). Mesenteric lymph node (MLN) granuloma predicted postoperative disease recurrence in patients with CD after ileocolic resection (ICR). This study was aimed to identify factors associated with MLN granulomas in a cohort of CD patients underwent ICR. METHODS: The study group consisted of 18 patients with CD who underwent the index ICR between 2004 and 2012 and had MLN granulomas...
January 14, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28079626/complications-and-disease-recurrence-after-primary-ileocecal-resection-in-pediatric-crohn-s-disease-a-multicenter-cohort-analysis
#3
Kay Diederen, Lissy de Ridder, Patrick van Rheenen, Victorien M Wolters, Maria L Mearin, Gerard M Damen, Tim G de Meij, Herbert van Wering, Laura A Tseng, Matthijs W Oomen, Justin R de Jong, Cornelius E Sloots, Marc A Benninga, Angelika Kindermann
BACKGROUND: Studies on the outcome of ileocecal resection in pediatric Crohn's disease (CD) have a limited follow-up and fail to assign predictors of adverse outcomes. Therefore, we aimed to investigate (I) the complication and disease recurrence rates and (II) identify risk factors for these adverse outcomes after ileocecal resection for pediatric CD. METHODS: This is a retrospective cohort analysis of all children (<18 years) that underwent ileocecal resection as first intestinal resection for CD derived from 7 tertiary hospitals in the Netherlands (1990-2015)...
January 6, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28079620/clostridium-difficile-infection-and-risk-of-colectomy-in-patients-with-inflammatory-bowel-disease-a-bias-adjusted-meta-analysis
#4
Yingxi Chen, Luis Furuya-Kanamori, Suhail A Doi, Ashwin N Ananthakrishnan, Martyn Kirk
BACKGROUND: Clostridium difficile infection (CDI) is a common complication of inflammatory bowel diseases (IBDs) and is associated with worse outcome. Variable rates of colectomy have been reported among IBD complicated by CDI. We conducted a systematic review and meta-analysis of studies to assess the association between CDI and colectomy among patients with IBD. METHODS: The literature was systematically searched using PubMed from inception through April 2016...
January 10, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28068895/can-surgery-for-inflammatory-bowel-disease-be-personalized
#5
Antonino Spinelli, Alessandra Marano, Claudio Bacchelli, Nicolò Maria Mariani, Marco Montorsi, Paulo Gustavo Kotze
In the treatment of Inflammatory Bowel Diseases (IBD) despite advances in medical therapies, surgery has maintained a leading role in the management of complications of the disease, as well as in cases of failure of medical therapy. Surgery has become more and more minimally invasive, struggling for a difficult balance between guidelines and personalized treatment tailored on the single patient's need. In the present paper, the authors discuss the possible role for a personalization in debated fields of surgical treatment of Crohn&s disease and ulcerative colitis...
January 5, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28066859/the-long-term-outcome-of-anti-tnf-alpha-therapy-in-perianal-crohn-s-disease
#6
J Rayen, T Currie, R B Gearry, F Frizelle, T Eglinton
BACKGROUND: The aim of the present study was to evaluate the long-term outcomes of anti-tumour necrosis factor alpha therapy in perianal Crohn's disease and identify factors predicting response to treatment. METHODS: Data from hospital clinical records and coding databases were retrospectively reviewed from a tertiary care hospital in Christchurch, New Zealand. The study included 75 adult patients with perianal Crohn's disease commenced on anti-tumour necrosis factor alpha therapy from January 2000 to December 2012...
January 9, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28058018/factors-associated-with-surgery-in-patients-with-intra-abdominal-fistulizing-crohn-s-disease
#7
Shaul Yaari, Ariel Benson, Eyal Aviran, Naama Lev Cohain, Ran Oren, Jacob Sosna, Eran Israeli
AIM: To characterize radiological and clinical factors associated with subsequent surgical intervention in Crohn's disease (CD) patients with intra-abdominal fistulae. METHODS: From a cohort of 1244 CD patients seen over an eight year period (2006 to 2014), 126 patients were identified as having intra-abdominal fistulae, and included in the study. Baseline patient information was collected from the medical records. Imaging studies were assessed for: anatomic type and number of fistulae; diameter of the inflammatory conglomerate; length of diseased bowel; presence of a stricture with pre-stenotic dilatation; presence of an abscess; lymphadenopathy; and the degree of bowel enhancement...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28051217/changes-of-crohn-s-disease-phenotype-over-time
#8
Afef Ouaz, Monia Fekih, Asma Labidi, Nadia Ben Mustapha, Meriem Serghini, Lilia Zouiten, Jalel Boubaker, Azza Filali
Background - Crohn's disease is a clinically heterogeneous condition. Our aim was to identify the phenotype evolution of Crohn's disease over time according to the Montreal Classification and to precise predictive factors of the need for immunosuppressant treatment or surgery. Methods - We included Crohn's disease patients who were followed up for at least 5 years. We excluded patients who were lost to follow up before five. Patients were classified according to the Montreal classification for phenotype at diagnosis and five years later...
June 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28045769/diverting-ileostomy-for-the-treatment-of-severe-refractory-pediatric-inflammatory-bowel-disease
#9
Elizabeth C Maxwell, Noor Dawany, Robert N Baldassano, Petar Mamula, Peter Mattei, Lindsey Albenberg, Judith R Kelsen
OBJECTIVES: Diverting ileostomy is used as a temporizing therapy in patients with perianal Crohn disease; however, little data exist regarding its use for colonic disease. The primary aim of the present study was to determine the role of diversion in severe refractory colonic inflammatory bowel disease (IBD) in a pediatric population. METHODS: Retrospective study of patients who underwent diverting ileostomy at The Children's Hospital of Philadelphia from 2000 to 2014 for the management of severe, refractory colonic IBD...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28041688/laparoscopic-surgical-treatment-of-ileocecal-crohn-s-disease-impact-of-obesity-on-short-term-results
#10
David Parés, Awad Shamali, Karen Flashman, Daniel O'Leary, Asha Senapati, John Conti, Amjad Parvaiz, Jim Khan
INTRODUCTION: The aim of our study was to analyse the short-term outcomes of laparoscopic surgery for a no medical responding ileocolic Cohn's disease in a single centre according to the presence of obesity. METHODS: A cross-sectional study was performed including all consecutive patients who underwent laparoscopic resection for ileocecal Crohn's disease from November 2006 to November 2015. Patients were divided according to body mass index ≥ 30 kg/m(2) in order to study influence of obesity in the short-term outcomes...
December 29, 2016: Cirugía Española
https://www.readbyqxmd.com/read/28039532/histopathologic-risk-stratification-of-stage-iib-colorectal-cancer
#11
Koji Komori, Takashi Kinoshita, Taihei Oshiro, Seiji Ito, Tetsuya Abe, Yoshiki Senda, Kazunari Misawa, Yuichi Ito, Norihisa Uemura, Seiji Natsume, Jiro Kawakami, Akira Ouchi, Masayuki Tsutsuyama, Takahiro Hosoi, Itaru Shigeyoshi, Tomoyuk Akazawa, Daisuke Hayashi, Hideharu Tanaka, Yasuhiro Shimizu
PURPOSE: To stratify stage IIB (pT4a PN0) colorectal cancer in terms of histopathologic findings. METHODS: We reviewed the medical records of 80 patients who underwent surgery for stage IIB colorectal cancer. The disease-free survival (DFS) and overall survival (OS) rates were evaluated and correlated with the presence or absence of "Tumor Necrosis", "Crohn's-like lymphoid reaction", and "Perineural Invasion". RESULTS: Patients with "Tumor Necrosis" had significantly lower DFS rates (p < 0...
December 30, 2016: Surgery Today
https://www.readbyqxmd.com/read/28039168/correlation-of-the-rutgeerts-score-and-recurrence-of-crohn-s-disease-in-patients-with-end-ileostomy
#12
Vasutakarn Chongthammakun, Andre Fialho, Andrea Fialho, Rocio Lopez, Bo Shen
BACKGROUND: Recurrence of Crohn's disease (CD) can occur after surgery, including end ileostomy (EI). The Rutgeerts score (RS) was developed to predict postsurgical CD recurrence via ileocolonoscopy in patients having ileocolonic resection. The role of ileoscopic evaluation via stoma for assessing recurrence of CD has not been investigated. The aim of this study was to evaluate the role of ileoscopy for predicting disease recurrence in CD patients after EI with the use of RS. METHODS: A total of 73 eligible CD patients with at least two ileoscopies in our institution following EI were included...
December 30, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/28018097/contraindications-for-video-capsule-endoscopy
#13
REVIEW
Dirk Bandorski, Niehls Kurniawan, Peter Baltes, Reinhard Hoeltgen, Matthias Hecker, Dominik Stunder, Martin Keuchel
Video capsule endoscopy (VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality. In patients with a higher incidence of stenosis, as in an established diagnosis of Crohn's disease, clinical signs of obstruction, prior radiation or surgical small bowel resection, a preceding test with the self-dissolving patency capsule can override this contraindication...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28003021/smoking-influences-the-need-for-surgery-in-patients-with-the-inflammatory-bowel-diseases-a-systematic-review-and-meta-analysis-incorporating-disease-duration
#14
M Ellen Kuenzig, Sang Min Lee, Bertus Eksteen, Cynthia H Seow, Cheryl Barnabe, Remo Panaccione, Gilaad G Kaplan
BACKGROUND: Studies examining the association between smoking and the need for surgery in patients with Crohn's disease and ulcerative colitis have reached inconsistent conclusions. These studies often do not differentiate between patients undergoing early surgery and patients having surgery later in their disease course. Our study examined the association between smoking status and time to first bowel resection in patients with Crohn's disease and ulcerative colitis. METHODS: We searched MEDLINE and EMBASE for studies (n = 12) reporting on the association between smoking status (current, former, and never) and surgery in IBD, and incorporated disease duration in the analysis...
December 21, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/28002130/a-pooled-analysis-of-efficacy-safety-and-long-term-outcome-of-endoscopic-balloon-dilation-therapy-for-patients-with-stricturing-crohn-s-disease
#15
Dominik Bettenworth, Anders Gustavsson, Ashish Atreja, Rocio Lopez, Curt Tysk, Gert van Assche, Florian Rieder
BACKGROUND: Endoscopic balloon dilation (EBD) is widely used to manage Crohn's disease-associated strictures. However, most studies of the safety and efficacy are small and heterogenous. We performed a combined analysis of published studies and evaluated 676 comprehensive individual participant data sets to determine the overall effects of EBD. METHODS: Citations from the Embase, MEDLINE, and the Cochrane library from 1991 through 2013 were systematically reviewed, and references of cited articles were assessed for relevant publications...
January 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28000196/-analysis-of-clinical-characteristics-of-perianal-crohn-s-disease-in-a-single-center
#16
Ping Zhu, Yugen Chen, Yunfei Gu, Hongjin Chen, Xiaohai An, Yingrui Cheng, Ying Gao, Bolin Yang
OBJECTIVE: To discuss the clinical features of perianal Crohn disease (PCD). METHODS: Clinical data of 52 PCD patients who were treated at the Department of Colorectal Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine from June 2011 to October 2014 were analyzed retrospectively. Montreal classification, clinical symptoms, the subtype of perianal lesions, history of perianal surgery and medical treatment, disease active indexes, serum inflammation markers and nutritional indexes were included...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28000195/-risk-factors-of-early-surgical-intervention-in-crohn-s-disease-patients-with-spontaneous-intra-abdominal-abscess
#17
Xiaosheng He, Xiaobin Zheng, Lei Lian, Chi Zhou, Xiaowen He, Xiaojian Wu, Ping Lan
OBJECTIVE: To investigate the risk factors of early surgical intervention in Crohn's disease (CD) patients with spontaneous intra-abdominal abscess. METHODS: Clinical data of 94 CD patients with spontaneous intra-abdominal abscess admitted to The Sixth Affiliated Hospital of Sun Yat-sen University between May 2008 and Dec 2015 were analyzed retrospectively. Univariate and multivariate analysis were applied to evaluate the early surgery risk of CD patients with spontaneous intra-abdominal abscess using logistic regression model...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28000189/-diagnosis-and-surgical-treatment-for-rectovaginal-fistula
#18
Wanjin Shao
Rectovaginal fistulas are distressing conditions to patients and present a therapeutic challenge to surgeons. Whether the etiology of the fistula is obstetric, Crohn's disease-related, or cryptoglandular, a thorough anatomy evaluation is required in order to select the correct repair. No single surgical technique is suitable for all rectovaginal fistulas as of now. Less invasive surgery should be selected in primary repair, and endorectal advancement flap repair was recommended as the first line therapy in most guidelines for the treatment of rectovaginal fistulas...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27998853/-immunological-balance-of-cd8-cd28-cd8-cd28-t-lymphocytes-can-predict-gastrointestinal-hemorrhage-in-patients-with-inflammatory-bowel-disease
#19
Shi-Xue Dai, Hong-Xiang Gu, Gang Wu, Tao Zhong, Hong-Jian Jian, Yong-le Zhan, Min-Hai Zhang, Yong Gao, Jun Xu, Dong-Sheng Chen, Guang-Jie Liao, Yan-Ling Feng, Hong-Bo Liu, Ying Zou, Hong-Gang Chi
OBJECTIVE: To evaluate the sensitivity and specificity of CD8(+)CD28(+)/CD8(+)CD28(-) T lymphocyte balance in predicting the gastrointestinal hemorrhage (GH) in patients with inflammatory bowel disease (IBD). METHODS: Forty-nine IBD patients, including 30 with ulcerous colitis (UC) and 19 with Crohn's disease (CD), were enrolled to test peripheral blood CD8(+)CD28(+) and CD8(+)CD28(-) T cells using flow cytometry. All the patients were followed up for one year. The receiver-operating characteristic (ROC) curves were used to test the efficiency of CD8(+)CD28(+)/CD8(+)CD28(-) T lymphocyte balance to predict GH...
December 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27997435/risk-of-surgery-and-mortality-in-elderly-onset-inflammatory-bowel-disease-a-population-based-cohort-study
#20
Geoffrey C Nguyen, Charles N Bernstein, Eric I Benchimol
BACKGROUND: As the prevalence of inflammatory bowel disease (IBD) increases in the elderly population, we sought to characterize IBD-related outcomes in this population. METHODS: We identified incident IBD cases in Ontario, Canada between 1999 and 2008 and categorized subjects by age at diagnosis as young adults (18-40 yr); middle-age adults (41-64 yr); and elderly (≥65 yr) from within population-based health administrative data. We determined the risk of IBD-related surgery and mortality in those with elderly-onset IBD compared with other age groups...
December 16, 2016: Inflammatory Bowel Diseases
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