Nipple valve anastomosis for preventing recurrence of Crohn disease in the neoterminal ileum after ileocolic resection. A prospective pilot study.
BACKGROUND
Crohn disease may recur within months in the neoterminal ileum after ileocolic resection. Coloileal reflux may be a factor contributing to recurrence. This study tests the effect of a nipple valve anastomosis in preventing symptomatic and endoscopic neoileal recurrence.


METHODS
Between January 1993 and April 1997, 25 patients with Crohn disease were resected and anastomosed with an ileocolic nipple valve. Postoperatively, the patients were given 5-aminosalicylic acid, 0.75-3 g/daily. Regular follow-up included the Harvey-Bradshaw index, ileocolonoscopy, and hydrocolonic sonography.


RESULTS
After 1 year 2 of 25 patients (8%) had a symptomatic and 3 of 23 patients (13%) an endoscopic recurrence. There was no symptomatic neoileal recurrence between 1 and 5 years. After 3 years 6 of 13 patients (46%) had an endoscopic recurrence. After 5 years 4 of 11 patients (36%) had a symptomatic recurrence.


CONCLUSIONS
These results may suggest that a nipple valve anstomosis delays and perhaps prevents symptomatic recurrence of Crohn disease in the neoterminal ileum.
Bakkevold
K E
KE
Dept. of Surgery, Haugesund Hospital, Norway.
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D003106:Colon / Q000601:surgery*; D003424:Crohn Disease / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors