title: Risk and significance of endoscopic/radiological evidence of recurrent Crohn's disease.
abstract: OBJECTIVE
  The aim of this study was to determine the risk of endoscopic/radiological recurrence of Crohn's disease postoperatively and the long-term outcome.
  
  
  METHODS
  A randomized placebo-controlled trial was performed to determine the effectiveness of mesalamine in preventing recurrent Crohn's disease postoperatively. Patients in the control group were examined endoscopically/radiologically before entry into and annually during the trial. Findings were classified as minimal or severe.
  
  
  RESULTS
  There were 76 patients (49 men and 37 women; mean age, 37.1 +/- 13.2 years). Fifty (61.7%) had terminal ileal resections. Overall, 55 endoscopic/radiological recurrences were observed in 51 patients (67.1%). Expressed actuarially, the recurrence rate was 27.5% at 1 year (95% confidence interval [CI], 15.8%-37.6%), 60.8% at 2 years (95% CI, 46%-71.3%), and 77.3% at 3 years (95% CI, 62.7%-86.3%). Nineteen (37%) were symptomatic and 12 (24%) were initially asymptomatic but later became symptomatic (mean, 13.0 +/- 8.8 months), whereas 20 (39%) remained asymptomatic (mean, 16.9 +/- 17.4 months). Patients with severe endoscopic/radiological disease were significantly more likely to be or become symptomatic than those with minimal disease (23 of 32 vs. 8 of 19, respectively; P = 0.0437).
  
  
  CONCLUSIONS
  This study suggests that postoperative endoscopic/radiological recurrences occur later than previously reported. Furthermore, many of these patients, especially with minimal disease, will remain asymptomatic.
authors.affiliation: Department of Surgery, University of Toronto, Ontario, Canada.
authors.forename: R S
authors.initials: RS
authors.lastname: McLeod
authors.forename: B G
authors.initials: BG
authors.lastname: Wolff
authors.forename: A H
authors.initials: AH
authors.lastname: Steinhart
authors.forename: P W
authors.initials: PW
authors.lastname: Carryer
authors.forename: K
authors.initials: K
authors.lastname: O'Rourke
authors.forename: D F
authors.initials: DF
authors.lastname: Andrews
authors.forename: J E
authors.initials: JE
authors.lastname: Blair
authors.forename: J R
authors.initials: JR
authors.lastname: Cangemi
authors.forename: Z
authors.initials: Z
authors.lastname: Cohen
authors.forename: J B
authors.initials: JB
authors.lastname: Cullen
authors.forename: R G
authors.initials: RG
authors.lastname: Chaytor
authors.forename: G R
authors.initials: GR
authors.lastname: Greenberg
authors.forename: N M
authors.initials: NM
authors.lastname: Jaffer
authors.forename: K N
authors.initials: KN
authors.lastname: Jeejeebhoy
authors.forename: R L
authors.initials: RL
authors.lastname: MacCarty
authors.forename: R L
authors.initials: RL
authors.lastname: Ready
authors.forename: L H
authors.initials: LH
authors.lastname: Weiland
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome