Abstract | BACKGROUND: AIM: To perform a systematic review and meta-analysis to evaluate the rate, risk factors and outcomes of CD recurrence after TC-PI. METHODS: In a systematic review ending 31 March 2016, we identified 18 cohort studies (1438 adults) who underwent TC-PI for colonic CD (median follow-up, 7.4 years; interquartile range, 5.3-9.0). We estimated pooled rates [with 95% confidence interval (CI)] of clinical and surgical recurrence, and risk factors for disease recurrence. RESULTS: On meta-analysis, the risk of clinical recurrence after TC-PI was 28.0% (95% CI, 21.7-35.3; 14 studies, 260/1004 patients), with a 5 and 10-year median cumulative rate of 23.5% (range, 7-35) and 40% (range, 11-60) respectively. The risk of surgical recurrence was 16.0% (95% CI, 11.1-22.7; 10 studies; 183/1092 patients), with a 5 and 10-year median cumulative rate of 10% (range, 3-29) and 18.5% (range, 14-34) respectively. The risk of clinical and surgical recurrence in patients without ileal disease at baseline was 11.5% (95% CI, 7.7-16.8) and 10.4% (95% CI, 4.5-22.5) respectively. History of ileal disease was associated with 3.2 times higher risk of disease recurrence (RR, 3.2; 95% CI, 1.8-5.6). Other inconsistent risk factors for disease recurrence were penetrating disease and young age at disease onset. CONCLUSIONS:
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Authors | M Fumery, P S Dulai, P Meirick, A M Farrell, S Ramamoorthy, W J Sandborn, S Singh |
Journal | Alimentary pharmacology & therapeutics
(Aliment Pharmacol Ther)
Vol. 45
Issue 3
Pg. 381-390
(02 2017)
ISSN: 1365-2036 [Electronic] England |
PMID | 27928830
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Copyright | © 2016 John Wiley & Sons Ltd. |
Topics |
- Adult
- Cohort Studies
- Colectomy
(adverse effects)
- Crohn Disease
(pathology, surgery)
- Female
- Follow-Up Studies
- Humans
- Ileostomy
(adverse effects)
- Male
- Middle Aged
- Postoperative Complications
(etiology)
- Recurrence
- Risk Factors
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