Abstract
Background
Ileo-colic resection (ICR) is an important therapeutic option for Crohn’s disease (CD) patients. There are limited updated data of clinical and endoscopic post-operative recurrence (POR) in pediatric patients with CD for the long run. We aimed to determine recurrence rates following ICR over an extended period of time and asses its risk factors.
Methods
This is a single-center retrospective review of 35 patients with CD between the ages of 6 and 17.9 years who required ICR between 2003 and 2021 at Schneider Children Medical Center of Israel. Medical charts were reviewed at different time-points post-ICR.
Results
Clinical recurrence following ICR was demonstrated in only 11.4% and 28.6% (n = 4, n = 10) in the first two and five years—much lower rates than what was reported so far. We found no specific risk factor that correlated with clinical recurrence, although patients that were treated with early prophylaxis of anti-TNF medications following ICR tend to have less recurrence.
Conclusions
We found lower POR following ICR, especially in the first years after surgery—which can be attributed to close surveillance and early medical treatment. Such surveillance seems to improve recurrence rates in the first years following ICR.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Markowitz J, Markowitz JE, Bousvaros A et al (2005) Workshop report: prevention of postoperative recurrence in Crohn’s disease. J Pediatr Gastroenterol Nutr 41:145–151
De Cruz P, Kamm MA, Prideaux L et al (2012) Postoperative recurrent luminal Crohn’s disease: a systematic review. Inflamm Bowel Dis 18:758–777
Baldassano RN, Han PD, Jeshion WC et al (2001) Pediatric Crohn’s disease: risk factors for postoperative recurrence. Am J Gastroenterol 96:2169–2176
Piekkala M, Pakarinen M, Ashorn M et al (2013) Long-term outcomes after surgery on pediatric patients with Crohn disease. J Pediatr Gastroenterol Nutr 56:271–276
Yanai H, Kagrammanova A, Knyazev O, Sabino J et al (2022) Endoscopic postoperative recurrence in crohn’s disease after curative ileocecal resection with early prophylaxis by anti -TNF, Vedolizumab or Ustekinumab: a real world multicenter European study jjac100. https://doi.org/10.1093/ecco-jcc/jjac100
Regueiro M, Velayos F, Greer JB et al (2017) American gastroenterological association institute technical review on the management of crohn's disease after surgical resection. Gastroenterology
Elizabeth AS, Lauren J, Priya R, Sergey K, Alexander G, Marla CD (2021) Outcomes of primary ileocolic resection for pediatric Crohn disease in the biologic era. J Pediatr Gastroenterol Nutr 73(6):710–716
Christensen B, Erlich J, Gibson PR et al (2020) Histologic healing is more strongly associated with clinical outcomes in ileal Crohn’s disease than endoscopic healing. Clin Gastroenterol Hepatol 18:2518.e1-2525.e1
Diederen K, de Ridder L, van Rheenen P et al (2017) Complications and disease recurrence after primary ileocecal resection in pediatric Crohn’s disease: a multicenter cohort analysis. Inflamm Bowel Dis 23:272–282
Funding
None.
Author information
Authors and Affiliations
Contributions
Y.D, D.S.D. and I.S wrote the main manuscript text. M.P and M.T performed statistical analysis. All authors reviewed the manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Statement of ethics
This study was approved by the local ethics committee at Rabin Medical Center.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Dreznik, Y., Samuk, I., Shouval, D.S. et al. Recurrence rates following ileo-colic resection in pediatric patients with Crohn’s disease. Pediatr Surg Int 39, 83 (2023). https://doi.org/10.1007/s00383-022-05346-1
Accepted:
Published:
DOI: https://doi.org/10.1007/s00383-022-05346-1