title: Risk of postoperative recurrence and postoperative management of Crohn's disease.
abstract: Crohn's disease (CD) is a chronic inflammatory disease of the digestive tract with systemic manifestations. Etiology is unknown, even if immunological, genetic and environmental factors are involved. The majority of CD patients require surgery during their lifetime due to progressive bowel damage, but, even when all macroscopic lesions have been removed by surgery, the disease recurs in most cases. Postoperative management represents therefore a crucial mean for preventing recurrence. Several drugs and approaches have been proposed to achieve this aim. Endoscopic inspection of the ileocolic anastomosis within 1 year from surgery is widely encouraged, given that endoscopic recurrence is one of the greatest predictors for clinical recurrence. A strategy should be planned only after stratifying patients according to their individual risk of recurrence, avoiding unnecessary therapies when possible benefits are reduced, and selecting high-risk patients for more aggressive intervention.
authors.affiliation: Department and Chair of General Surgery, University of Milan, Istituto Clinico Humanitas IRCCS, Via Manzoni 5620089, Rozzano, Milan, Italy. antonino.spinelli@humanitas.it
authors.forename: Antonino
authors.initials: A
authors.lastname: Spinelli
authors.forename: Matteo
authors.initials: M
authors.lastname: Sacchi
authors.forename: Gionata
authors.initials: G
authors.lastname: Fiorino
authors.forename: Silvio
authors.initials: S
authors.lastname: Danese
authors.forename: Marco
authors.initials: M
authors.lastname: Montorsi
mesh_terms: D000714:Anastomosis, Surgical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019819:Budesonide / Q000627:therapeutic use; D003424:Crohn Disease / Q000473:pathology / Q000601:surgery* / Q000628:therapy*; D004724:Endoscopy / Q000379:methods; D005762:Gastroenterology / Q000379:methods*; D006801:Humans; D007249:Inflammation; D019804:Mesalamine / Q000627:therapeutic use; D011184:Postoperative Period; D012008:Recurrence; D012306:Risk; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D019804:Mesalamine; D019819:Budesonide