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Crohns surgery

S Renshaw, I L Silva, A Hotouras, S D Wexner, J Murphy, C Bhan
The purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed, using the text "robotic(s)" AND ("inflammatory bowel disease" OR "Crohn's" OR "Ulcerative Colitis"). Two investigators screened abstracts for eligibility. All English language full-text articles were reviewed for specified outcomes. Data were presented in a summarised and aggregate form, since the lack of higher-level evidence studies precluded meta-analysis...
March 15, 2018: Techniques in Coloproctology
Nan Lan, Bo Shen
Background: Current treatment modalities for anastomotic stricture in Crohn's disease (CD) include endoscopic balloon dilation (EBD) and surgery. We recently published a case series of inflammatory bowel disease patients treated with the novel endoscopic stricturotomy (ES). The aim of this case-control study was to compare the efficacy and safety of ES versus conventional EBD in the treatment of anastomotic strictures in CD patients. Methods: All eligible patients with CD anastomotic stricture who were treated with ES or EBD were included...
March 12, 2018: Inflammatory Bowel Diseases
Jildou Hoekstra, Aafke H C van Roon, Frank C Bekkering, Antonie J P van Tilburg, Rachel L West
INTRODUCTION: The aim of this study was to evaluate information provided on pregnancy, personal decision making, disease course, and outcome of pregnancy from a patient's perspective in a population of patients with inflammatory bowel disease (IBD) attending two general hospitals. PATIENTS AND METHODS: A questionnaire was sent to all female patients with IBD in two general hospitals in the Netherlands. The questionnaire comprised four sections: (i) demographic data and medication use (ii) details on previous pregnancies and reasons for not becoming pregnant, (iii) outcome of pregnancies before IBD diagnosis, and (iv) outcome of pregnancies after IBD diagnosis...
March 14, 2018: European Journal of Gastroenterology & Hepatology
Kristy L Rialon, Eileen Crowley, Natashia M Seemann, Aleixo Muise, Jacob C Langer
PURPOSE: The timing of J-pouch surgery following colectomy for children with very early-onset colitis is controversial, with some advocating early reconstruction and others delaying reconstruction because of fear that the colitis may be owing to Crohn's disease (CD). We sought to determine the long-term incidence of CD in this population and whether there may be clinical features that predict the risk of CD. METHODS: Children with noninfectious colitis diagnosed prior to age 10, who underwent subtotal colectomy and ileostomy from 2000 to 2015, were reviewed...
February 8, 2018: Journal of Pediatric Surgery
Onofrio Antonio Catalano, Vincent Wu, Umar Mahmood, Alberto Signore, Mark Vangel, Andrea Soricelli, Marco Salvatore, Debra Gervais, Bruce R Rosen
This study investigates the performance of PET/MR versus each sub-modality alone in the assessment of active inflammation in patients with Crohn disease, when compared to surgery as standard of reference. Sensitivity for detecting active inflammation was 91.5% for PET, 80% for MR, and 88% for PET/MR. Specificity for active inflammation was 74% for PET, 87% for MR, and 93% for PET/MR. Diagnostic accuracy was 84% for PET, 83% for MR, and 91% for PET/MR. In conclusion, PET/MR is significantly more accurate than either sub-modality alone and more specific than PET alone in the detection of active inflammation in patients with Crohn disease...
2018: American Journal of Nuclear Medicine and Molecular Imaging
Igors Iesalnieks, Melanie Hoene, Theresa Bittermann, Hans J Schlitt, Christina Hackl
Background: Studies addressing the role of mechanical bowel preparation (MBP) in Crohn's disease (CD) patients are lacking. Methods: Consecutive elective colorectal resections for CD have been included in the present analysis. Exclusion criteria were small bowel resections not including colon, urgent surgeries, surgeries for cancer, and abdominoperineal resections for perianal disease. MBP was performed routinely between 1992 and 2004, omitted between 2005 and 2015, and reintroduced in 2016...
February 24, 2018: Inflammatory Bowel Diseases
Ole Haagen Nielsen, Lars Rejnmark, Alan C Moss
Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, is a chronic and unpredictable characterized by alternating periods of remission interspersed with relapses. In recent years accumulating support for an immunomodulating effect of vitamin D on both the innate and adaptive immune system has been presented. Through the vitamin D receptor, the active form of vitamin D, 1,25(OH)2D, induces antimicrobial peptide secretion, decrease dendritic cell activity, and promotes Th2 and regulatory T cell development and activity...
February 24, 2018: Journal of Crohn's & Colitis
Antonio Rispo, Nicola Imperatore, Anna Testa, Luigi Bucci, Gaetano Luglio, Giovanni Domenico De Palma, Matilde Rea, Olga Maria Nardone, Nicola Caporaso, Fabiana Castiglione
Background: In the management of Crohn's Disease (CD) patients, having a simple score combining clinical, endoscopic and imaging features to predict the risk of surgery could help to tailor treatment more effectively. AIMS: to prospectively evaluate the one-year risk factors for surgery in refractory/severe CD and to generate a risk matrix for predicting the probability of surgery at one year. Methods: CD patients needing a disease re-assessment at our tertiary IBD centre underwent clinical, laboratory, endoscopy and bowel sonography (BS) examinations within one week...
March 8, 2018: Journal of Crohn's & Colitis
Blaise Hamel, May Wu, Elizabeth O Hamel, Dorsey M Bass, K T Park
Background: Severe colitis flare from ulcerative colitis (UC) or Crohn's disease (CD) may be refractory to corticosteroids and antitumour necrosis factor (TNF) agents resulting in high colectomy rates. We aimed to describe the utility of tacrolimus to prevent colectomy during second-line vedolizumab initiation after corticosteroid and anti-TNF treatment failure in paediatric severe colitis. Methods: A retrospective cohort analysis was performed between 1 October 2014 and 31 October 2016 at a single tertiary care centre...
2018: BMJ Open Gastroenterology
Katsunori Matsueda, Tatsuya Toyokawa, Masahiro Sakata, Isao Fujita, Jouichiro Horii
This case report refers to a 31-year-old patient with an 11-year history of Crohn's disease. The patient presented with an edematous elevated lesion in the splenic flexure. Two histological analyses revealed no signs of obvious dysplasia, and the patient subsequently began infliximab treatment. Nine months later, a worsening of the stricture of the edematous elevated lesion was observed in the splenic flexure, and transverse colonic resection was performed. A histological investigation of the lesion in the splenic flexure revealed advanced adenocarcinoma...
March 9, 2018: Internal Medicine
Franco Marinello, Miquel Kraft, Nuria Ridaura, Francesc Vallribera, Eloy Espín
INTRODUCTION: The treatment of anal fistula with the OTSC® (over-the-scope-clip) proctology device involves the placement of an elastic alloy clip called Nitinol on the internal fistula opening to achieve fistula healing. The aim of this study was to analyze preliminary results of this technique in a case series. METHODS: This was a retrospective analysis of patients who underwent OTSC® clip placement for fistula-in-ano treatment between June 2015 and March 2017 at a specialized colorectal unit...
March 7, 2018: Cirugía Española
P F Vollebregt, A A van Bodegraven, T M L Markus-de Kwaadsteniet, D van der Horst, R J F Felt-Bersma
BACKGROUND: Patient reported outcomes regarding perianal disease and faecal incontinence in the community-based inflammatory bowel disease population are poorly described. AIMS: To determine the impacts of perianal disease and faecal incontinence on quality of life and employment in inflammatory bowel disease patients. METHODS: For this cross-sectional study, a comprehensive survey was sent out to members of the Dutch National Crohn's and Colitis patient organisation...
March 9, 2018: Alimentary Pharmacology & Therapeutics
Lucrezia Laterza, Anna Chiara Piscaglia, Laura Maria Minordi, Iolanda Scoleri, Luigi Larosa, Andrea Poscia, Fabio Ingravalle, Arianna Amato, Sergio Alfieri, Alessandro Armuzzi, Giovanni Cammarota, Antonio Gasbarrini, Franco Scaldaferri
AIM: To evaluate if a single and/or combined (clinical, endoscopic and radiological) assessment could predict clinical outcomes in Crohn's disease (CD). METHODS: We prospectively evaluated 57 CD cases who underwent both a colonoscopy and a CT-enterography (CTE). Harvey-Bradshaw Index (HBi), SES-CD (and/or Rutgeerts score) and the radiological disease activity were defined to stratify patients according to clinical, endoscopic and radiological disease activity respectively...
March 7, 2018: Digestive Diseases
H Ooms, H U De Schepper, T G Moreels
BACKGROUND AND STUDY AIMS: Small bowel ulceration poses a limited, but difficult differential diagnosis. The most common causes are Crohn's disease (CD), NSAID-associated enteritis, lymphoma, cytomegaly virus infection and tuberculosis. A less known and relatively novel differential diagnosis is cryptogenic multifocal ulcerative stenosing enteritis (CMUSE). PATIENTS AND METHODS: ive patients referred for balloon-assisted enteroscopy for various reasons showed endoscopic features of CMUSE...
July 2017: Acta Gastro-enterologica Belgica
Ashish Joshi, Sushil Falodia, Naveen Kumar, R L Solanki
Strictures of the small intestine have been attributed many causes of Crohn's disease, nonsteroidal anti-inflammatory drugs, neoplastic, post-surgical, and corrosive ingestion. Opium as a cause of small intestine strictures has not been described. Six cases of opium addicts diagnosed with small intestine strictures were selected after excluding the possible etiology of strictures. Investigations like upper gastrointestinal endoscopy, colonoscopy (in patients with small intestinal obstruction), barium meal follow-through, and histopathology of strictures were done in all patients...
March 7, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Stefano Scaringi, Annamaria Di Bella, Luca Boni, Francesco Giudici, Carmela Di Martino, Daniela Zambonin, Ferdinando Ficari
BACKGROUND AND AIMS: Surgical management of Crohn's colitis represents one of the most complex situations in colorectal surgery. Segmental colectomy (SC) and total abdominal colectomy with ileorectal anastomosis (TAC-IRA) are the most common procedures, but there are few available data on their long-term outcome. The aim of the present study was to analyze the long-term outcome of patients who underwent segmental colectomy for Crohn's colitis, with regard to the risk for total abdominal colectomy...
March 6, 2018: International Journal of Colorectal Disease
Amy L Lightner, Kellie L Mathis, Chung Sang Tse, John H Pemberton, Bo Shen, Gursimran Kochlar, Amandeep Singh, Parambir S Dulai, Samuel Eisenstein, William J Sandborn, Lisa Parry, Sarah Stringfield, David Hudesman, Feza Remzi, Edward V Loftus
Background: Vedolizumab is now widely available for the treatment of moderate to severe ulcerative colitis (UC) and Crohn's disease (CD). We sought to quantify the rates of postoperative complications with preoperative vedolizumab compared with anti-tumor necrosis factor (anti-TNF) therapy. Methods: A multicenter retrospective review of adult inflammatory bowel disease (IBD) patients who underwent an abdominal operation between May 20, 2014, and December 31, 2015, was performed...
March 2, 2018: Inflammatory Bowel Diseases
B Lo, M K Vester-Andersen, I Vind, M Prosberg, M Dubinsky, C A Siegel, F Bendtsen, J Burisch
Background and Aim: Crohn's disease [CD] is a progressive inflammatory bowel disease that can lead to complications such as strictures or penetrating disease, and ultimately surgery. Few population-based studies have investigated the predictors for disease progression and surgery in CD according to the Montreal classification. We aimed to identify clinical predictors associated with complicated CD in a Danish population-based inception cohort during the biologic era. Methods: All incident patients with CD in a well-defined Copenhagen area, between 2003 and 2004, were followed prospectively until 2011...
February 28, 2018: Journal of Crohn's & Colitis
Nan Lan, Luca Stocchi, Jean H Ashburn, Tracy L Hull, Scott R Steele, Conor P Delaney, Bo Shen
BACKGROUND & AIMS: Few studies have compared endoscopic balloon dilation (EBD) with ileocolic resection (ICR) in the treatment of primary ileocolic strictures in patients with Crohn's disease (CD). METHODS: We performed a retrospective study to compare post-procedure morbidity and surgery-free survival among 258 patients with primary stricturing ileo (colic) CD (B2, L1, or L3) initially treated with primary EBD (n=117) or ICR (n=258) from 2000 through 2016. Patients with penetrating disease were excluded from the study...
March 2, 2018: Clinical Gastroenterology and Hepatology
Ashish Malhotra, Parkpoom Phatharacharukul, Charat Thongprayoon
BACKGROUND: Repeat hospitalizations in veterans with inflammatory bowel disease (IBD) are understudied. The early readmission rate and potentially modifiable risk-factors for 90-day readmission in veterans with IBD were studied to avert avoidable readmissions. METHODS: A retrospective cohort study was conducted using the data from veterans who were admitted to the Minneapolis VA Medical Center (MVMC) between January 1, 2007, and December 31, 2013, for an IBD-related problem...
February 8, 2018: Military Medical Research
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