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Predictors of recurrence of Crohn's disease after ileocolectomy: A review

World Journal of Gastroenterology 2014年第39期20卷 14393-14406页

作者： Tara M Connelly Evangelos Messaris Division of Colon and Rectal Surgery Department of Surgery The Pennsylvania State UniversityCollege of MedicineHersheyPA 17033United States

Recurrence after ileocolectomy for Crohn’s disease (CD) is common and occurs in up to 80% of patients. Such recurrence can result in repeated surgical interventions, an increased need for medical treatment and, frequently, an impaired quality of life. The aim of this overview is to provide a summary of the factors associated with disease recurrence after ileocolectomy for CD. Recurrence can be measured clinically or endoscopically using established scoring systems. Radiology and serologic tests can also be used, oftentimes in conjunction with endoscopy and/or clinical findings. Many patient and operative factors as well as pharmacologic treatments have been studied as potential predictors of recurrence. Of these, only smoking and immunomodulatory or biologic medical treatment have repeatedly been shown to effect recurrence. Genetic predictors have been studied and suggested but further evaluation in larger cohorts is necessary. This paper highlights validated, reproducible scoring systems for recurrence and the key findings of studies including patient demographics, operative techniques, various pharmacological treatments and histological findings as predictors of recurrence post ileocolectomy in CD.

关键词： Crohn’ s disease Ileocolectomy Recurrence surgical genetics Inflammatory bowel disease

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