[Postoperative recurrence in Crohn's disease. Risk factors and methods of prevention].
Postoperative recurrences art frequent in Crohn's disease. Early recurrent lesions in the neoterminal ileum after ileocoIonic anastomosis is the most important risk factor for symptomatic recurrence of Crohn's disease after curative surgical resection. Others risk factors are ileocolonic anastomosis, perforating indication of surgery and smoking status. Many drugs have been evaluated for the prevention of clinical postoperative recurrence: Antibiotics, particularly metronidazole ornidazole, and a little benefice of mesalamine. Azathioprine and 6 mercaptopurine have been recently evaluated; with a not clear clinical effect for prevention of clinical recurrence after resection in Crohn's disease. Several authors have proposed an empiric strategy for the prevention of recurrence after curative resection, based essentially on existence and severity of early endoscopic recurrence.
Karoui
Sami
S
Service de Gastro-entérologie A. Hôpital la Rabra, Tunis.
Kallel
Lamia
L
Boubaker
Jalel
J
Filali
Azza
A
D000465:Algorithms; D000714:Anastomosis, Surgical; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use; D003106:Colon / Q000601:surgery; D003424:Crohn Disease / Q000175:diagnosis / Q000517:prevention & control* / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage / Q000627:therapeutic use; D019804:Mesalamine / Q000008:administration & dosage / Q000627:therapeutic use; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012307:Risk Factors; D055502:Secondary Prevention; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors
D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D008795:Metronidazole; D019804:Mesalamine; D015122:Mercaptopurine; D001379:Azathioprine