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crohn's disease surgery

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https://www.readbyqxmd.com/read/28542298/early-anti-tnf-immunomodulator-therapy-is-associated-with-better-long-term-clinical-outcomes-in-asian-patients-with-crohn-s-disease-with-poor-prognostic-factors
#1
Eun Hye Oh, Kyunghwan Oh, Minkyu Han, Hyungil Seo, Kiju Chang, Sun-Ho Lee, Gwang-Un Kim, Eun Mi Song, Myeongsook Seo, Ho-Su Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye
Although early treatment of Crohn's disease (CD) patients with anti-tumor necrosis factor (TNF) agents or immunomodulators (IMs) may improve long-term outcomes, especially those with poor prognostic factors, their effectiveness in Asians remains unclear. In this study, Korean patients with CD naïve to both intestinal surgery and intestinal complications, and with at least two risk factors for progression (diagnosis at age <40 years, systemic corticosteroid treatment <3 months after diagnosis, and perianal fistula at diagnosis) were retrospectively analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28534335/-consistency-analysis-between-preoperative-ct-enterography-and-intraoperative-findings-in-patients-undergoing-surgery-for-crohn-s-disease
#2
Jianbo Yang, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
OBJECTIVE: To evaluate the diagnostic value of preoperative CT enterography (CTE) on obstruction, fistula and abscess formation compared to intraoperative findings in patients undergoing surgery for Crohn's disease(CD), aiming to provide reference to clinical practice. METHODS: Preoperative CTE data of 176 CD patients confirmed by clinic, endoscopy, imaging, operation and pathology at the Department of General Surgery in Nanjing Jinling Hospital from January 2013 to December 2015 were enrolled in retrospective cohort study...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28534264/adherence-to-an-elemental-diet-for-preventing-postoperative-recurrence-of-crohn-s-disease
#3
Nobuyoshi Ohara, Tsunekazu Mizushima, Hideki Iijima, Hidekazu Takahashi, Satoshi Hiyama, Naotsugu Haraguchi, Takahiro Inoue, Junichi Nishimura, Shinichiro Shinzaki, Taishi Hata, Chu Matsuda, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori
PURPOSE: An elemental diet (ED) can suppress inflammation in patients with Crohn's disease (CD); however, adherence to this diet is difficult. We examined the correlation between ED adherence and the postoperative recurrence of CD. METHODS: The subjects of this study were 38 patients who underwent intestinal resection with anastomosis. We defined ED adherence as consuming the average daily ED dose (≥900 kcal/day) for 2 years after surgery. Patients who did not adhere to the ED were allocated to the non-ED group...
May 22, 2017: Surgery Today
https://www.readbyqxmd.com/read/28533920/inflammatory-bowel-disease-efficient-remission-maintenance-is-crucial-for-cost-containment
#4
REVIEW
Giovanni C Actis, Rinaldo Pellicano
The inflammatory bowel diseases (IBD) are chronic incurable inflammatory disorders of the gut. Some 10% run a downhill course, requiring emergency medical support and often surgery; another small subset are monogenic, and, threatening pediatric patients, are the challenge of these days. The majority of the IBDs, however, are polygenic low-penetrance diseases, running a lifetime waxing-and-waning course. The prevalent trend is towards a slow worsening and steady cost increase. Each and all drugs of the available arsenal exhibit strengths and weaknesses: Mesalamines are chiefly effectively for mild-moderate colitis, and do not work in Crohn's; steroids do not control some 40% of the ulcerative colitis cases, and are not indicated for Crohn's; thiopurines are effective in the maintenance of the IBDs but do not prevent relapses on withdrawal; biologics are still being used empirically (not monitored) causing further increase of their cost over that of hospitalization...
May 6, 2017: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28533918/5-aminosalicylates-to-maintain-remission-in-crohn-s-disease-interpreting-conflicting-systematic-review-evidence
#5
EDITORIAL
Morris Gordon
5-Aminosalicylates are a class of anti-inflammatory agents that have been used for decades in inflammatory bowel disease. Whilst they are first line for induction and an option for maintenance of remission in ulcerative colitis, the picture in Crohn's disease is variable. For maintenance of remission, key Cochrane systematic reviews have found conflicting results between the medical and surgical induced contexts. In this piece, the possible reasons for this are considered. It is proposed that clinicians should consider 5-aminosalicylates agents an option to maintain remission post-surgery...
May 6, 2017: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28523361/can-laparoscopic-surgery-prevent-incisional-hernia-in-patients-with-crohn-s-disease-a-comparison-study-of-750-patients-undergoing-open-and-laparoscopic-bowel-resection
#6
Tomas M Heimann, Santosh Swaminathan, Adrian J Greenstein, Alexander J Greenstein, Sergey Khaitov, Randolph M Steinhagen, Barry A Salky
BACKGROUND: Incisional hernia (IH) is a frequent occurrence following open surgery for Crohn's disease (CD). This study compares the IH rates of patients with CD undergoing open versus laparoscopic bowel resection. METHODS: Seven hundred and fifty patients with CD operated by the authors at the Mount Sinai Medical Center, New York, USA, were reviewed from a prospectively maintained surgical database. Five hundred patients with Crohn's disease undergoing open surgery were compared to 250 patients undergoing laparoscopic bowel resection...
May 18, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28522956/fecal-microbiota-transplantation-for-refractory-crohn-s-disease
#7
Seon Ho Bak, Hyun Ho Choi, Jinhee Lee, Mi Hee Kim, Youn Hee Lee, Jin Su Kim, Young-Seok Cho
Approximately one-third of patients with Crohn's disease do not respond to conventional treatments, and some experience significant adverse effects, such as serious infections and lymphoma, and many patients require surgery due to complications. Increasing evidence suggests that specific changes in the composition of gut microbiota, termed as dysbiosis, are a common feature in patients with inflammatory bowel disease (IBD). Dysbiosis can lead to activation of the mucosal immune system, resulting in chronic inflammation and the development of mucosal lesions...
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28522945/current-status-of-endoscopic-balloon-dilation-for-crohn-s-disease
#8
REVIEW
Fumihito Hirai
The therapeutic target in Crohn's disease (CD) has been raised to the achievement of mucosal healing. Although effective treatments that target cytokines and other molecules has been widely used for CD, intestinal strictures are still a major cause of surgery. Endoscopic balloon dilation (EBD) is known to be an effective and safe intervention for intestinal strictures in CD. Since frequent intestinal resection often results in short bowel syndrome and can decrease the quality of life, EBD can help avoid surgery...
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28522944/preoperative-use-of-anti-tumor-necrosis-factor-therapy-in-crohn-s-disease-promises-and-pitfalls
#9
REVIEW
Paulo Gustavo Kotze, Subrata Ghosh, Willem A Bemelman, Remo Panaccione
Recent advances in medical and surgical therapy were achieved during the last two decades in the management of Crohn's disease (CD). Anti-tumor necrosis factor (anti-TNF) agents are widely used worldwide. However, a significant proportion of patients still need surgical resections. The impact of previous exposure to these agents on the perioperative and postoperative outcomes is still controversial. In this critical review, we aimed to position the strategy of intentional preoperative use of anti-TNF agents in the management of CD...
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28520589/distance-to-specialist-care-and-disease-outcomes-in-inflammatory-bowel-disease
#10
Nienke Z Borren, Grace Conway, William Tan, Elizabeth Andrews, John J Garber, Vijay Yajnik, Ashwin N Ananthakrishnan
BACKGROUND: Optimal treatment of inflammatory bowel disease (IBD) requires specialized health care. Patients frequently travel long distances to obtain care for IBD, which may hinder regular care and affect outcomes adversely. METHODS: This study included patients with established Crohn's disease or ulcerative colitis receiving care at a single referral center between January 2005 and August 2016. Distance to our health care center from the zip code of residence was determined for each patient and classified into quartiles...
May 16, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28508235/the-presence-of-postoperative-infectious-complications-is-associated-with-the-risk-of-early-postoperative-clinical-recurrence-of-crohn-s-disease
#11
Zhen Guo, Lei Cao, Feilong Guo, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
BACKGROUND: The purpose of the study was to identify risk factors for early clinical and surgical recurrence in Crohn's disease (CD) patients who underwent intestinal resection. METHOD: This was a retrospective study. Consecutive patients who underwent intestinal resection with a primary anastomosis from January 2011-December 2014 were enrolled. Gender, age at surgery, clinical phenotypes of CD, serum albumin and C-reactive protein level the day before surgery, smoking status at surgery, anastomosis technique, number of anastomoses, details of postoperative complications, the postoperative prophylactic treatment were assessed to figure out risk factors for postoperative clinical and surgical recurrence within 1 year after the initial resection by univariate and then multivariate analysis...
May 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28508024/pilot-study-of-endoscopic-retrograde-3-dimensional-computed-tomography-enteroclysis-for-the-assessment-of-crohn-s-disease
#12
Hiroki Tanabe, Takahiro Ito, Yuhei Inaba, Katsuyoshi Ando, Yoshiki Nomura, Nobuhiro Ueno, Shin Kashima, Kentaro Moriichi, Mikihiro Fujiya, Toshikatsu Okumura
PURPOSE: Endoscopic retrograde ileography (ERIG) is developed in our institute and applied clinically for the diagnosis and assessment of the Crohn's disease activity. We have further improved the technique using 3-dimensional - computed tomography enteroclysis (3D-CTE) and conducted a retrospective study to determine the feasibility and the diagnostic value of endoscopic retrograde 3D-CTE (ER 3D-CTE) in Crohn's disease patients in a state of remission. METHODS: Thirteen Crohn's patients were included in this pilot study...
2017: European Journal of Radiology Open
https://www.readbyqxmd.com/read/28502591/cd8-cd28-cd8-cd28-t-cell-equilibrium-can-predict-the-active-stage-for-patients-with-inflammatory-bowel-disease
#13
Shi-Xue Dai, Hong-Xiang Gu, Qian-Yi Lin, Shao-Zhuo Huang, Tiao-Si Xing, Qing-Fang Zhang, Gang Wu, Min-Hua Chen, Wan-Er Tan, Hong-Jian Jian, Zhong-Wen Zheng, Tao Zhong, Min-Hai Zhang, Xing-Fang Cheng, Peng Huang, Guang-Jie Liao, Wei-Hong Sha
BACKGROUND/AIM: The balance of blood CD8(+)CD28(+)/CD8(+)CD28(-) T cells has been verified to be vital for patients with ulcerative colitis (UC), but their role in inflammatory bowel disease (IBD) remains unknown. This investigation aimed to evaluate the efficiency of the balance in predicting the active stage in IBD patients. METHODS: Fifty-three IBD subjects, including 31 UC and 22 Crohn's disease (CD) patients, were enrolled, and their peripheral blood CD8(+)CD28(+) and CD8(+)CD28(-) T cell levels were tested using flow cytometry...
May 10, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28502329/serum-adipocytokine-levels-as-surrogate-markers-for-disease-activity-of-crohn-s-disease
#14
Su Hwan Kim, Seung Hyeon Jang, Ji Won Kim, Byeong Gwan Kim, Kook Lae Lee, You Sun Kim, Dong Soo Han, Joo Sung Kim
BACKGROUND: Determining inflammatory activity is crucial for assessing disease activity and for tailoring therapy in patients with Crohn׳s disease (CD). This study aimed to evaluate adipocytokine levels in patients with CD and to determine whether they can serve as surrogate markers for disease activity. MATERIALS AND METHODS: Serum samples and information regarding the clinical features of patients in the CD Network Project registry were collected from March 2009 to February 2012...
May 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28498901/ecco-escp-consensus-on-surgery-for-crohn-s-disease
#15
Willem A Bemelman, Janindra Warusavitarne, Gianluca M Sampietro, Zuzana Serclova, Oded Zmora, Gaetano Luglio, Anthony de Buck van Overstraeten, John P Burke, Christianne J Buskens, Colombo Francesco, Jorge Amil Dias, Rami Eliakim, Tomás Elosua, I Ethem Gecim, Sanja Kolacek, Jaroslaw Kierkus, Kaija-Leena Kolho, Jérémie H Lefevre, Monica Millan, Yves Panis, Thomas Pinkney, Richard K Russell, Chaya Shwaartz, Carolynne Vaizey, Nuha Yassin, André D'Hoore
No abstract text is available yet for this article.
May 11, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28498158/transmural-healing-is-associated-with-improved-long-term-outcomes-of-patients-with-crohn-s-disease
#16
Samuel R Fernandes, Rita V Rodrigues, Sónia Bernardo, João Cortez-Pinto, Isadora Rosa, João P da Silva, Ana R Gonçalves, Ana Valente, Cilénia Baldaia, Paula M Santos, Luís Correia, José Venâncio, Paula Campos, António D Pereira, José Velosa
BACKGROUND: Mucosal healing (MH) is currently accepted as one of the best treatment targets in Crohn's disease. However, even in patients with sustained MH, residual bowel wall inflammation can still be detected by cross-sectional imaging. The long-term benefits of obtaining transmural healing (TH) have not been previously assessed. METHODS: We performed an observational study including 214 patients with Crohn's disease with a magnetic resonance enterography (MRE) and colonoscopy performed within a 6-month interval...
May 11, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28496529/discontinuation-of-scheduled-infliximab-in-crohn-s-patients-with-clinical-remission-a-retrospective-single-center-study
#17
Huiqin Hu, Cheng Xiang, Chen Qiu, Zhao Chen, Silin Huang, Li Liang, Xinying Wang
BACKGROUND: It is crucial to determine whether infliximab (IFX) therapy could be safely interrupted in Crohn's disease (CD) patients with clinical remission. The outcome and risk predictors of relapse after IFX therapy stopped are controversial. The aim was to assess the relapse and predictive factors after IFX discontinuation in CD patients with clinical remission. METHODS: A retrospective cohort of CD patients with clinical remission who discontinued scheduled IFX therapy at Nanfang Hospital were included...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28489647/obesity-bariatric-surgery-and-crohn-s-disease
#18
Burton I Korelitz, Niket Sonpal, Judy Schneider, Arun Swaminath, Joseph Felder, Mitchell Roslin, Jeffrey Aronoff
BACKGROUND: Crohn's disease (CD) following bariatric surgery has been previously described. It is not clear whether the clinical entity is due to rapid metabolism of fat, change in the bacterial milieu of the bowel, the loss of defense mechanisms of the stomach, or even a coincidence. OBJECTIVES: To present observations which might serve to sort out these various etiologies. DESIGN: We present 5 cases of colitis, ileocolitis or enteritis, some with fistula formation, with clinical onset following bariatric surgery and add these to the 7 cases previously identified as CD reported elsewhere...
May 9, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28486256/one-year-clinical-outcomes-in-an-ibd-cohort-who-have-previously-had-anti-tnfa-trough-and-antibody-levels-assessed
#19
Donal Tighe, Barry Hall, Shivashini Kirthi Jeyarajah, Sinead Smith, Niall Breslin, Barbara Ryan, Deirdre McNamara
BACKGROUND: Loss of response (LOR) is a big concern for anti-TNFa therapies in inflammatory bowel disease. Immunomonitoring may be useful to optimize response rates and overcome secondary LOR. METHODS: This was an observational retrospective cohort study of a group of patients with inflammatory bowel disease on infliximab (IFX) and adalimumab (ADA) who had anti-TNFa trough and antibody levels measured, during maintenance phase of treatment. Anti-TNFa trough and antibody levels were measured using standard enzyme-linked immunosorbent assay techniques...
May 5, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28475826/effect-of-oral-tobacco-use-and-smoking-on-outcomes-of-crohn-s-disease-in-india
#20
Umang Arora, Ashwin N Ananthakrishnan, Saurabh Kedia, Sawan Bopana, P V Mouli, Dawesh P Yadav, Govind K Makharia, Vijay Yajnik, Vineet Ahuja
INTRODUCTION: Smoking has been linked with adverse outcomes in Crohn's disease(CD), however it is not known whether oral tobacco use affects disease outcomes in these patients. The study aimed to assess the association between smoking or oral tobacco(OT) and outcomes in CD. METHODS: Retrospective analysis was performed on prospectively maintained records of CD patients from 2004-2016. The parameters assessed included disease characteristics at baseline(location, behavior, age at onset, perianal disease, extra-intestinal manifestations), course pattern and outcomes (surgery, hospitalizations, immunomodulator or biologics use, and steroid requirement)...
May 5, 2017: Journal of Gastroenterology and Hepatology
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