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crohn's disease operation

Firas Rinawi, Amit Assa, Corina Hartman, Yael Mozer Glassberg, Vered Nachmias Friedler, Yoram Rosenbach, Ari Silbermintz, Noam Zevit, Raanan Shamir
BACKGROUND: Data describing the incidence and the risk factors for surgical interventions in pediatric Crohn's disease (CD) is inconsistent. Our aim was to describe the rates of intestinal surgery and to identify associated risk factors in a large cohort of children with CD. METHODS: Medical charts of 482 children with CD from the Schneider Pediatric Inflammatory Bowel Disease cohort who were diagnosed between 1981 and 2013 were carefully reviewed retrospectively...
October 13, 2016: Inflammatory Bowel Diseases
Mohammad A Khasawneh, Nicholas P McKenna, Zaid M Abdelsattar, Angela Johnson, Eric J Dozois, John H Pemberton, Kellie L Mathis
BACKGROUND: IPAA is the surgical treatment of choice for patients with ulcerative colitis. Limited data exist on how obesity impacts the ability of the surgeon to successfully create an IPAA. OBJECTIVE: We aimed to determine how BMI affects the ability to successfully complete the operation. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted at a single tertiary care center. PATIENTS: We included all of the patients undergoing an IPAA for ulcerative colitis between January 2002 and August 2013 at our institution...
November 2016: Diseases of the Colon and Rectum
Danyta I Tedjo, Agnieszka Smolinska, Paul H Savelkoul, Ad A Masclee, Frederik J van Schooten, Marieke J Pierik, John Penders, Daisy M A E Jonkers
Monitoring mucosal inflammation is crucial to prevent complications and disease progression in Crohn's disease (CD). Endoscopy is the current standard, but is invasive. Clinical activity scores and non-invasive biochemical markers do not correlate well with mucosal inflammation. Microbial perturbations have been associated with disease activity in CD. Therefore, we aimed to investigate its potential use to differentiate CD patients in remission from those with an exacerbation. From 71 CD patients repeated fecal samples were collected, resulting in 97 active disease and 97 remission samples based on a combination of biochemical and clinical parameters...
October 13, 2016: Scientific Reports
Daperno Marco, Comberlato Michele, Bossa Fabrizio, Alessandro Armuzzi, Biancone Livia, Bonanomi G Andrea, Cosintino Rocco, Lombardi Giovanni, Mangiarotti Roberto, Papa Alfredo, Pica Roberta, Luca Grassano, Pagana Guido, D'Incà Renata, Orlando Ambrogio, Rizzello Fernando
BACKGROUNDS AND AIMS: Endoscopic outcomes are increasingly used in clinical trials and in routine practice for inflammatory bowel disease (IBD), in order to reach more objective patient evaluations than using only clinical features. However reproducibility of endoscopic scoring systems used to categorize endoscopic activity was reported to be suboptimal.Aim of this study was to analyse the inter-rated agreement of non-dedicated Gastroenterologists on IBD endoscopic scoring systems, and to explore the effects of a dedicated training programme on agreement...
October 4, 2016: Journal of Crohn's & Colitis
Natashia M Seemann, Sebastian K King, Abdul Elkadri, Thomas Walters, Joel Fish, Jacob C Langer
BACKGROUND/PURPOSE: Perianal Crohn's disease (PCD) can affect both quality of life and psychological wellbeing. A subset of pediatric patients with complex PCD require surgical intervention, although appropriate timing and treatment regimens remain unclear. This study aimed to describe a large pediatric cohort in a tertiary center to determine the range of surgical management in children with complex PCD. METHODS: A retrospective review of children requiring operative intervention for PCD over 13 years (2002-2014) was performed...
September 15, 2016: Journal of Pediatric Surgery
Erika Lehtola, Johanna Haapamäki, Martti A Färkkilä
BACKGROUND: Biological medications, particularly TNF-α inhibitors, are used increasingly for active inflammatory bowel disease (IBD). Even though they are superior to many older medications in achieving remission and mucosal healing, primary nonresponse and loss of response remain significant problems, and a remarkable proportion of patients still need surgery at some point. OBJECTIVE: To study the outcome of IBD patients treated with TNF-α inhibitors, either infliximab or adalimumab, with a two-year follow-up...
December 2016: Scandinavian Journal of Gastroenterology
Elliot G Arsoniadis, Yen-Yi Ho, Genevieve B Melton, Robert D Madoff, Chap Le, Mary R Kwaan
BACKGROUND: Previous reports on racial disparities in the treatment of Crohn's Disease (CD) in African American (AA) patients have shown differences in both medical and surgical treatments in this population. No study thus far has examined the effect of AA race on outcomes after surgery for CD. METHODS: Utilizing the National Surgical Quality Improvement Program (NSQIP) Participant User File (PUF) for years 2005-2013, we examined the effect of AA race on post-operative complications in patients with CD undergoing intestinal surgery...
September 28, 2016: Journal of Crohn's & Colitis
Vu Nguyen, Rajan Kanth, Joshua Gazo, Dario Sorrentino
Postoperative recurrence (POR) of Crohn's disease is common after surgical resection. How to best manage POR remains uncertain. Areas covered: In this review, we will first describe the natural course and the best modalities to diagnose this surgical sequela. We will then focus on the potential risk factors for relapse and highlight the main shortcomings in the current study designs and endoscopic and clinical scoring systems, which may partly explain the unexpected outcomes of recent clinical trials. Finally, we will propose a strategy to address the management of POR...
October 7, 2016: Expert Review of Gastroenterology & Hepatology
Koushik Herle, Susan Jehangir
Wireless capsule endoscopy (WCE) is one of the great milestones in the field of gastroenterology. It is versatile in image acquisition, painless and can reach parts of the small bowel not amenable to conventional endoscopy. The commonest complication with WCE is retention of the capsule. We report a case of retained capsule in a child who was being investigated for obscure gastrointestinal bleeding (OGIB). Operative intervention was required for its retrieval after two weeks of expectant management.
September 2016: APSP Journal of Case Reports
R L Prosst, A K Joos
BACKGROUND: One hundred consecutive applications of a new clipping device, the OTSC(®) Proctology (Ovesco Endoscopy AG), were analyzed to assess its efficacy for the treatment of complex anorectal fistulas. METHODS: In patients with anorectal fistulas, minimally invasive surgery with the OTSC(®) Proctology system was performed according to a standardized technique: the fistula tract was debrided using a special fistula brush, and the clip was applied on the internal fistula opening...
September 26, 2016: Techniques in Coloproctology
Carmen-Monica Preda, Larisa Elena Fulger, Lucian Negreanu, Mircea Manuc, Irina Sandra, Mircea-Mihai Diculescu
AIM: Perform a comparison between adalimumab (ADA) and infliximab (IFX) in treating post-operative recurrence of Crohn's disease (a comparative analysis of efficacy and safety). METHODS: From the 267 patients treated with Adalimumab or Infliximab between January 2005 and June 2014 in Romania, 44 received anti- TNF (tumor necrosis factor) therapy for prevention of post-operative recurrence. A comparison between patients treated with IFX and ADA was made with the Chi- square and t- student test, with the aid of the statistical program Mini Tab 17...
October 2016: Revista Española de Enfermedades Digestivas
Quinton M Hatch, Rubina Ratnaparkhi, Alison Althans, Michael Keating, Ruel Neupane, Madhuri Nishtala, Eric K Johnson, Scott R Steele
BACKGROUND: The impact of modern medical management of inflammatory bowel disease (IBD) on surgical necessity and outcomes remains unclear. We hypothesized that surgery rates have decreased while outcomes have worsened due to operating on "sicker" patients since the introduction of biologic medications. METHODS: The Nationwide Inpatient Sample and ICD-9-CM codes were used to identify inpatient admissions for Crohn's disease and ulcerative colitis. Trends in IBD nutrition, surgeries, and postoperative complications were determined...
September 15, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Sheng Yu, Abhishek Chakrabortty, Katherine P Liao, Tianrun Cai, Ashwin N Ananthakrishnan, Vivian S Gainer, Susanne E Churchill, Peter Szolovits, Shawn N Murphy, Isaac S Kohane, Tianxi Cai
OBJECTIVE: Phenotyping algorithms are capable of accurately identifying patients with specific phenotypes from within electronic medical records systems. However, developing phenotyping algorithms in a scalable way remains a challenge due to the extensive human resources required. This paper introduces a high-throughput unsupervised feature selection method, which improves the robustness and scalability of electronic medical record phenotyping without compromising its accuracy. METHODS: The proposed Surrogate-Assisted Feature Extraction (SAFE) method selects candidate features from a pool of comprehensive medical concepts found in publicly available knowledge sources...
September 15, 2016: Journal of the American Medical Informatics Association: JAMIA
Jordi Rimola, Almudena Alvarez-Cofiño, Tamara Pérez-Jeldres, Carmen Ayuso, Ignacio Alfaro, Sonia Rodríguez, Elena Ricart, Ingrid Ordás, Julián Panés
BACKGROUND: Magnetic resonance enterography (MRE) is an accurate examination for assessing activity in Crohn's disease (CD). Various MRE indices have been developed for that purpose, but have not been directly compared. The aim of the study was to compare the diagnostic accuracy of three MRE indices for detecting and grading disease activity in CD, using endoscopy as gold standard. METHODS: MRE and ileocolonoscopies performed within 1 month in 43 patients with CD were analyzed...
September 6, 2016: Journal of Gastroenterology
Rahul Kalla, Nicholas A Kennedy, Nicholas T Ventham, Ray K Boyapati, Alex T Adams, Elaine R Nimmo, Micaela R Visconti, Hazel Drummond, Gwo-Tzer Ho, Rebecca J Pattenden, David C Wilson, Jack Satsangi
OBJECTIVES: There is an unmet need for novel blood-based biomarkers that offer timely and accurate diagnostic and prognostic testing in inflammatory bowel diseases (IBD). We aimed to investigate the diagnostic and prognostic utility of serum calprotectin (SC) in IBD. METHODS: A total of 171 patients (n=96 IBD, n=75 non-IBD) were prospectively recruited. A multi-biomarker model was derived using multivariable logistic regression analysis. Cox proportional hazards model was derived to assess the contribution of each variable to disease outcomes...
September 6, 2016: American Journal of Gastroenterology
Malek Smida, Nizar Miloudi, Rania Hefaiedh, Rabaa Zaibi
BACKGROUND: Surgery has played an essential role in the treatment of Crohn's disease. Emergency can reveal previously unknown complications whose treatment affects prognosis. PURPOSE OF STUDY: Indicate the incidence of indications in emergent surgery for Crohn's disease. Specify the types of procedures performed in these cases and assess the Results of emergency surgery for Crohn's disease postoperatively,  in short , medium and long term. METHODS: Retrospective analysis of collected data of 38 patients, who underwent surgical resection for Crohn's disease during a period of 19 years from 1992 to 2011 at the department of surgery in MONGI SLIM Hospital, and among them 17 patients underwent emergency surgery for Crohn's disease...
March 2016: La Tunisie Médicale
Tsunetaka Arai, Ken Takeuchi, Miyuki Miyamura, Rumiko Ishikawa, Akihiro Yamada, Masao Katsumata, Yoshinori Igarashi, Yasuo Suzuki
BACKGROUND & AIMS: Previous studies have not found a correlation between fecal level of calprotectin and small bowel Crohn's disease (CD). However, these studies evaluated patients mainly by ileocolonoscopy, which views up to only the terminal ileum rather than entire small intestine. We investigated whether level of fecal calprotectin (FC) is a marker of active CD of the small bowel, identified by balloon-assisted enteroscopy and computed tomography enterography (CTE). METHODS: We performed a prospective study of 123 patients with CD (35 with ileitis, 72 with ileocolitis, and 16 with colitis) evaluated by balloon-assisted enteroscopy from May 2012 through July 2015 at Toho University Sakura Medical Centre in Japan...
August 23, 2016: Clinical Gastroenterology and Hepatology
Amy L Lightner, Laura E Raffals, Kellie L Mathis, Robert R Cima, Chung Sang Tse, John H Pemberton, Eric J Dozois, Edward V Loftus
INTRODUCTION: Vedolizumab was recently approved by the Food and Drug Administration for the treatment of moderate to severe ulcerative colitis [UC] and Crohn's disease [CD]. No study to date has examined the rate of postoperative infectious complications among patients who received vedolizumab in the perioperative period. We sought to determine the 30-day postoperative infectious complication rate among inflammatory bowel disease [IBD] patients who received vedolizumab within 12 weeks of an abdominal operation as compared to patients who received tumour necrosis factor α [TNFα] inhibitors or no biological therapy...
August 19, 2016: Journal of Crohn's & Colitis
Chan-Seok Jeong, Dongsup Kim
BACKGROUND: Exome sequencing has been emerged as a primary method to identify detailed sequence variants associated with complex diseases including Crohn's disease in the protein-coding regions of human genome. However, constructing an interpretable model for exome sequencing data is challenging because of the huge diversity of genomic variation. In addition, it has been known that utilizing biologically relevant information in a rigorous manner is essential for effectively extracting disease-associated information...
2016: BMC Medical Genomics
Stanislaus Argeny, Anton Stift, Martina Mittlböck, Amy C Lord, Svenja Maschke, Mathias Schneeweiß, Stefan Riss
PURPOSE: Due to a lack of data, the present study was designed to assess the impact of advanced age on surgical characteristics and short-term outcome of patients operated on for symptomatic Crohn's disease. METHODS: We enrolled 454 consecutive Crohn's disease patients, who underwent intestinal resection at an academic tertiary referral center between 1997 and 2012. Patients were divided into 3 groups according to their age (group I: <30 years, group II: 30-50 years, group III: >50 years) and analyzed retrospectively...
September 2016: International Journal of Surgery
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