title: A survey of current practices used to maintain surgically induced remission following intestinal resection for Crohn's disease.
abstract: OBJECTIVE
  Post-operative Crohn's disease (CD) recurrence is common after intestinal resection. The European Crohn's and Colitis Organization has issued guidelines regarding the optimal post-operative management of patients who have undergone intestinal resection for CD. The current study aims to assess the current adjuvant therapy practices of colorectal surgeons and gastroenterologists.
  
  
  METHODS
  An electronic-based survey was sent to members of the Association of Coloproctology of Great Britain and Ireland and the Irish Society of Gastroenterology.
  
  
  RESULTS
  One hundred twenty-five surgeons and gastroenterologists responded. Gastroenterologists more frequently assessed for pre-clinical recurrence with serum inflammatory markers (97 vs. 51%, P < 0.001), faecal calprotectin (30 vs. 10%, P = 0.008) and ileocolonoscopy (67 vs. 23%, P < 0.001), while surgeons more frequently performed a CT scan (23 vs. 6%, P = 0.037). The majority of respondents estimated the 1-year endoscopic recurrence to be 10-25%, and 36% of respondents offered prophylaxis to all post-operative patients. Budesonide (8 vs. 4%, P = 0.006) and azathioprine/mercaptopurine (60 vs. 33%, P < 0.001) were more often prescribed for high-risk patients, while imidazole antibiotics (11 vs. 5%, P < 0.001) and 5-ASA derivatives were more often prescribed for low-risk patients (51 vs. 14%, P < 0.001).
  
  
  CONCLUSIONS
  Currently, surgeons and gastroenterologists involved in the peri-operative care of patients with CD underestimate the risk of recurrence following intestinal resection and under-utilize ileocolonoscopy to tailor adjuvant therapy.
authors.affiliation: Department of Colorectal Surgery, St Vincent's University Hospital and School of Medicine and Medical Sciences, University College Dublin, Dublin 4, Ireland. drjohnpburke@yahoo.ie
authors.forename: John P
authors.initials: JP
authors.lastname: Burke
authors.forename: Glen A
authors.initials: GA
authors.lastname: Doherty
authors.forename: P Ronan
authors.initials: PR
authors.lastname: O'Connell
mesh_terms: D003424:Crohn Disease / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control / Q000601:surgery*; D003710:Demography; D004724:Endoscopy; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006801:Humans; D007422:Intestines / Q000473:pathology / Q000601:surgery*; D007494:Ireland / Q000453:epidemiology; D060046:Maintenance Chemotherapy / Q000706:statistics & numerical data*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012008:Recurrence; D012074:Remission Induction; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology