title: CT enterography in evaluating postoperative recurrence of Crohn's disease after ileocolic resection: complementary role to endoscopy.
abstract: BACKGROUND
  Ileocolonoscopy is the gold standard to assess postoperative recurrence (POR) in patients with Crohn's disease (CD) who have undergone ileocolic resection. Although computed tomographic enterography (CTE) yields striking findings in the small bowel of CD, its role in POR is undefined. The aim of this study was to compare ileocolonoscopy and CTE for evaluating POR in CD.
  
  
  METHODS
  The analysis included 32 patients with CD with ileocolic resection. Ileocolonoscopy and CTE were performed within 1 week. Endoscopic recurrence was defined using Rutgeerts score (i0-i4), whereas CTE recurrence was assessed according to a previously validated CTE score (CTE0-CTE3). Patients were followed up for a maximum of 30 months, and the primary endpoint was reoperation.
  
  
  RESULTS
  There was a good correlation between endoscopic and CTE recurrence (r = 0.782, P < 0.0001). Moreover, CTE identified the presence of jejunal and proximal ileum disease (n = 7), fistula (n = 3), and abscess (n = 4). Therapeutic management was thereby modified in 8 of 32 patients (25.0%). Eleven patients received major reoperation. There was no significant difference regarding the rate of reoperation between subgroups' Rutgeerts score i3-4 and i0-2 (P > 0.05), whereas there was significant difference between subgroups' CTE2-CTE3 and CTE0-CTE1 (P < 0.05).
  
  
  CONCLUSIONS
  CTE is a reliable method in assessing POR in patients with CD who have undergone ileocolic resection. CTE may serve as an important complementary tool to endoscopy for evaluation of the postoperative course of CD.
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Ren
authors.initials: R
authors.lastname: Mao
authors.forename: Xiang
authors.initials: X
authors.lastname: Gao
authors.forename: Zhen-hua
authors.initials: ZH
authors.lastname: Zhu
authors.forename: Shi-ting
authors.initials: ST
authors.lastname: Feng
authors.forename: Bai-li
authors.initials: BL
authors.lastname: Chen
authors.forename: Yao
authors.initials: Y
authors.lastname: He
authors.forename: Yi
authors.initials: Y
authors.lastname: Cui
authors.forename: Zi-ping
authors.initials: ZP
authors.lastname: Li
authors.forename: Pin-jin
authors.initials: PJ
authors.lastname: Hu
authors.forename: Min-hu
authors.initials: MH
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D003106:Colon / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000473:pathology; D011379:Prognosis; D012008:Recurrence; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D055815:Young Adult