Management and outcomes of patients with Crohn's disease with first vs multiple surgeries: results from the PRACTICROHN study

Background: Surgery in Crohn's disease (CD) may be associated with poor prognosis and clinical and surgical recurrence. The aim of this study was to describe and compare the post-operative management and outcomes of patients with CD who underwent first vs recurrent surgeries. Methods: Observati...

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Autores: Iborra, M, Julia, B, Arranz, MDM, Barreiro-de Acosta, M, Gutierrez, A, Garcia-Sanchez, V, Taxonera, C, Gisbert, JP, Cea-Calvo, L, Domenech, E
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p5709
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones5709
Access Level:acceso abierto
Palabra clave:Crohn's disease
surgery
post-operative recurrence
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spelling Management and outcomes of patients with Crohn's disease with first vs multiple surgeries: results from the PRACTICROHN studyIborra, MJulia, BArranz, MDMBarreiro-de Acosta, MGutierrez, AGarcia-Sanchez, VTaxonera, CGisbert, JPCea-Calvo, LDomenech, ECrohn's diseasesurgerypost-operative recurrenceBackground: Surgery in Crohn's disease (CD) may be associated with poor prognosis and clinical and surgical recurrence. The aim of this study was to describe and compare the post-operative management and outcomes of patients with CD who underwent first vs recurrent surgeries. Methods: Observational study that included adult CD patients from 26 Spanish hospitals who underwent ileocolonic resection with ileocolonic anastomosis between January 2007 and December 2010. Data were retrospectively collected from the medical records. Results: Data from 314 patients were analysed, of whom 262 (83%) underwent first surgery and 52 (17%) referred to previous CD surgeries. Baseline characteristics were similar between the two groups except for a higher rate of stricturing behavior at diagnosis among re-operated patients (P = 0.03). After surgery, a higher proportion of re-operated patients received prophylactic treatment with immunomodulators compared with patients with first surgery (P = 0.04). In re-operated patients, time to clinical recurrence was not associated with the fact of receiving or not prophylaxis, whereas, in patients with first surgery, recurrence-free survival was greater when prophylaxis was received (P = 0.03). Conclusions: After surgery, a higher proportion of patients with previous surgeries received prophylactic treatment with immunomodulators compared with patients with first surgery. Although prophylactic treatment was beneficial for preventing clinical recurrence in patients operated on for the first time, it did not significantly reduce the risk of further recurrence in patients with previous surgeries. This suggests that effective prophylactic therapies are still needed in this subset of patients.OXFORD UNIV PRESS2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones5709Gastroenterology ReportISSN: 20520034reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p57092026-06-12T10:20:37Z
dc.title.none.fl_str_mv Management and outcomes of patients with Crohn's disease with first vs multiple surgeries: results from the PRACTICROHN study
title Management and outcomes of patients with Crohn's disease with first vs multiple surgeries: results from the PRACTICROHN study
spellingShingle Management and outcomes of patients with Crohn's disease with first vs multiple surgeries: results from the PRACTICROHN study
Iborra, M
Crohn's disease
surgery
post-operative recurrence
title_short Management and outcomes of patients with Crohn's disease with first vs multiple surgeries: results from the PRACTICROHN study
title_full Management and outcomes of patients with Crohn's disease with first vs multiple surgeries: results from the PRACTICROHN study
title_fullStr Management and outcomes of patients with Crohn's disease with first vs multiple surgeries: results from the PRACTICROHN study
title_full_unstemmed Management and outcomes of patients with Crohn's disease with first vs multiple surgeries: results from the PRACTICROHN study
title_sort Management and outcomes of patients with Crohn's disease with first vs multiple surgeries: results from the PRACTICROHN study
dc.creator.none.fl_str_mv Iborra, M
Julia, B
Arranz, MDM
Barreiro-de Acosta, M
Gutierrez, A
Garcia-Sanchez, V
Taxonera, C
Gisbert, JP
Cea-Calvo, L
Domenech, E
author Iborra, M
author_facet Iborra, M
Julia, B
Arranz, MDM
Barreiro-de Acosta, M
Gutierrez, A
Garcia-Sanchez, V
Taxonera, C
Gisbert, JP
Cea-Calvo, L
Domenech, E
author_role author
author2 Julia, B
Arranz, MDM
Barreiro-de Acosta, M
Gutierrez, A
Garcia-Sanchez, V
Taxonera, C
Gisbert, JP
Cea-Calvo, L
Domenech, E
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Crohn's disease
surgery
post-operative recurrence
topic Crohn's disease
surgery
post-operative recurrence
description Background: Surgery in Crohn's disease (CD) may be associated with poor prognosis and clinical and surgical recurrence. The aim of this study was to describe and compare the post-operative management and outcomes of patients with CD who underwent first vs recurrent surgeries. Methods: Observational study that included adult CD patients from 26 Spanish hospitals who underwent ileocolonic resection with ileocolonic anastomosis between January 2007 and December 2010. Data were retrospectively collected from the medical records. Results: Data from 314 patients were analysed, of whom 262 (83%) underwent first surgery and 52 (17%) referred to previous CD surgeries. Baseline characteristics were similar between the two groups except for a higher rate of stricturing behavior at diagnosis among re-operated patients (P = 0.03). After surgery, a higher proportion of re-operated patients received prophylactic treatment with immunomodulators compared with patients with first surgery (P = 0.04). In re-operated patients, time to clinical recurrence was not associated with the fact of receiving or not prophylaxis, whereas, in patients with first surgery, recurrence-free survival was greater when prophylaxis was received (P = 0.03). Conclusions: After surgery, a higher proportion of patients with previous surgeries received prophylactic treatment with immunomodulators compared with patients with first surgery. Although prophylactic treatment was beneficial for preventing clinical recurrence in patients operated on for the first time, it did not significantly reduce the risk of further recurrence in patients with previous surgeries. This suggests that effective prophylactic therapies are still needed in this subset of patients.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones5709
url https://isabial.portalinvestigacion.com/publicaciones5709
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv OXFORD UNIV PRESS
publisher.none.fl_str_mv OXFORD UNIV PRESS
dc.source.none.fl_str_mv Gastroenterology Report
ISSN: 20520034
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
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