Impact of endoscopic monitoring in postoperative Crohns disease patients already receiving pharmacological prevention of recurrence
Rev. esp. enferm. dig
; 107(10): 586-590, oct. 2015. tab, ilus
Artigo
em Inglês
| IBECS
| ID: ibc-141421
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
BACKGROUND:
Current guidelines address the initiation of treatment to prevent postoperative recurrence (PR) after ileo-cecal resection in Crohn's disease (CD), but appropriate management of postoperative CD patients who are already receiving treatment to prevent PR is yet to be defined. Usefulness of endoscopic monitoring in this scenario remains uncertain.AIMS:
To evaluate the usefulness of endoscopy-based management of postoperative CD patients who are already under pharmacological prevention of PR.METHODS:
Retrospective review of clinical outcome of all CD patients with ileo-cecal resection who underwent postoperative colonoscopy between 2004 and 2013 at our centre. Postoperative endoscopic findings were classified as no endoscopic recurrence (Rutgeerts i0-i1) or endoscopic recurrence (Rutgeerts i2-i4). Patients with endoscopic recurrence were classified as 'endoscopy-based management (EBM)' if treatment step-up after endoscopy, or 'non EBM (N-EBM)'. Clinical recurrence was considered if re-operation, CD related hospitalization or treatment change. Time until clinical recurrence or the end of the follow up was considered.RESULTS:
One hundred sixty six patients initially identified. One hundred twenty nine (77%) under pharmacological prevention of PR at the time of colonoscopy were analyzed 34% were receiving aminosalicylates, 50% thiopurines, 11% anti-TNF, 5% combo. Colonoscopy showed endoscopic recurrence in 57% of patients; those with N-EBM were more likely to have clinical recurrence than patients with EBM along the follow up (p = 0.01). Conclussions Endoscopic monitoring could be useful in postoperative CD patients also in patients already receiving pharmacological treatment to prevent PRRESUMEN
No disponible
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Espanha
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
Problema de saúde:
Objetivo 10: Doenças transmissíveis
Base de dados:
IBECS
Assunto principal:
Doença de Crohn
/
Colonoscopia
/
Endoscopia
Tipo de estudo:
Guia de prática clínica
/
Estudo observacional
/
Estudo prognóstico
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. esp. enferm. dig
Ano de publicação:
2015
Tipo de documento:
Artigo
Instituição/País de afiliação:
Hospital Universitario Puerta de Hierro Majadahonda/Spain