title: Postoperative recurrent luminal Crohn's disease: a systematic review.
abstract: Despite improved immunosuppressive therapy, surgical resection is still often required for uncontrolled inflammatory disease and the stenosing and perforating complications of Crohn's disease. However, surgery is not curative. A majority of patients develop disease recurrence at or above the anastomosis. Subclinical endoscopically identifiable recurrence precedes the development of clinical symptoms; identification and treatment of early mucosal recurrence may therefore prevent clinical recurrence. Therapy to achieve mucosal healing should now be the focus of postoperative therapy. A number of clinical risk factors for the development of earlier postoperative recurrence have been identified, and reasonable evidence is now available regarding the efficacy of drug therapies in preventing recurrence. This evidence now needs to be incorporated into prospective treatment strategies.
authors.affiliation: Department of Gastroenterology and Medicine, St Vincent's Hospital, Melbourne, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: De Cruz
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kamm
authors.forename: Lani
authors.initials: L
authors.lastname: Prideaux
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Allen
authors.forename: Paul V
authors.initials: PV
authors.lastname: Desmond
mesh_terms: D017668:Age of Onset; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D003113:Colonoscopy / Q000379:methods / Q000706:statistics & numerical data; D003424:Crohn Disease / Q000188:drug therapy / Q000235:genetics / Q000601:surgery*; D005260:Female; D020022:Genetic Predisposition to Disease; D006099:Granuloma / Q000453:epidemiology; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D065227:Transfusion Reaction; D016896:Treatment Outcome