New Inflammatory Bowel Disease Study Findings Have Been Reported by Investigators at University of Amsterdam (The Predictive Value of Inflammation At lleocecal Resection Margins for Postoperative Crohn's Recurrence: a Cohort Study)

摘要

2021 SEP 17(NewsRx)-Bya News Reporter-Staff News Editor at Disease Prevention Daily-Investigators discuss new findings in Digestive System Diseases and Conditions - Inflammatory Bowel Disease. According to news reporting from Amsterdam, Netherlands, by NewsRx journalists, research stated, "Resections for Crohn's disease should be limited and only resect macroscopically affected bowel. However recent studies suggest microscopic inflammation at resection margins as a predictor for postoperative recurrence." The news correspondents obtained a quote from the research from the University of Amsterdam, "The clinical impact remains unclear; as non-uniform pathological criteria have been used. The aim of this study was to assess the predictive value of pathological characteristics at ileocecal resection margins for recurrence. Both resection margins of 106 consecutive patients undergoing ileocecal resection for Crohn's disease between 2002 and 2009 were revised and scored for active inflammation, myenteric plexitis, and granulomas. Pathological findings were correlated to recurrence, defined as recur- rent disease activity demonstrated by endoscopy (modified Rutgeerts score >= i2) requiring upscaling medical treatment, using multivariate analysis. Active inflammation was found at the proximal and distal resection margin in 27% and 15% of patients, respectively, myenteric plexitis in 37% and 32%, respectively, and granulomas in 4% and 6%, respectively. In total, 47 out of 106 patients developed recurrence. Only active inflammation at the distal colonic resection margin was an independent significant predictor for recurrence (88% vs 43% vs 51% for distal, proximal, and no involved margins, respectively; P<0.01). Active inflammation at the distal colonic resection margin after ileocecal resection identifies a patient group at high risk for postoperative recurrence both at the anastomotic site and the colon because it identifies undiagnosed L3 disease.