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Curr Drug Targets. 2019 Mar 19. doi: 10.2174/1389450120666190320110809. [Epub ahead of print]

Prevention of postoperative recurrence in Crohn's disease: tailoring treatment to patient profile.

Author information

1
Department of Gastroenterology, Universidade Federal de São Paulo, São Paulo. Brazil.
2
IBD outpatient clinics, Catholic University of Paraná (PUCPR), Curitiba. Brazil.
3
IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Institute, Milan. Italy.
4
Department of Surgery and IBD Centre, Yokkaichi Hazu Medical Centre, Yokkaichi. Japan.

Abstract

Crohn's disease (CD) is an immune mediated condition characterized by transmural inflammation of the gut tissue, associated with progressive bowel damage often leading to surgical intervention. As operative resection of the damaged segment is not curative, a majority of patients undergoing intestinal resections for complicated CD present with disease recurrence within 3 years after intervention. Postoperative recurrence can be defined as endoscopic, clinical, radiological or surgical. Endoscopic recurrence rates within 1 year exceed 60% and the severity, according to the Rutgeerts' score, is associated with worse prognosis and can predict clinical recurrence (in up to 1/3 of the patients). Most importantly, about 50% of patients will undergo a reoperation after 10 years of their first intestinal resection. Therefore, prevention of postoperative recurrence in CD remains a challenge in clinical practice and should be properly managed. We aim to summarize the most recent data on the definition, risk factors, assessment and treatment of postoperative CD recurrence.

KEYWORDS:

Crohn’s disease; postoperative recurrence; prevention; surgery treatment

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