title: Tailored treatment according to early post-surgery colonoscopy reduces clinical recurrence in Crohn's disease: a retrospective study.
abstract: BACKGROUND
  After intestinal resection for Crohn's disease, the severity of endoscopic recurrence in the first year following surgery is predictive of clinical outcome. Aim of the study was to assess the impact on clinical recurrence of tailored therapy based on endoscopic findings in the first year following surgery for Crohn's disease.
  
  
  METHODS
  All patients who underwent an intestinal resection for Crohn's disease between 1995 and 2005 at Saint-Louis Hospital were retrospectively included. Time-to-clinical recurrence was compared in two groups: patients who had systematic ileocolonoscopy 6-12 months after intestinal surgery with tailored treatment according to the severity of endoscopic lesions (group C) and patients without systematic endoscopic evaluation (group NC).
  
  
  RESULTS
  132 patients (group C=90, group NC=42) were included. Probabilities of clinical recurrence were significantly lower in group C (21% and 26% at 3 and 5 years, respectively) compared with group NC (31% and 52% at 3 and 5 years respectively, p=0.01).
  
  
  CONCLUSIONS
  Tailored treatment according to endoscopic assessment after ileocolonic resection is significantly associated with reduced clinical recurrence rate.
authors.affiliation: Department of Gastroenterology, University Hospital of Saint-Louis, Paris, France. Electronic address: clotilde.baudry@sls.aphp.fr.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Baudry
authors.affiliation: Department of Gastroenterology, University Hospital of Saint-Louis, Paris, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Pariente
authors.affiliation: Department of Gastroenterology, University Hospital of Saint-Louis, Paris, France.
authors.forename: Nelson
authors.initials: N
authors.lastname: Lourenço
authors.affiliation: Department of Gastroenterology, University Hospital of Saint-Louis, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Simon
authors.affiliation: Department of Digestive Surgery, University Hospital of Saint-Louis, Paris, France.
authors.forename: Mircea
authors.initials: M
authors.lastname: Chirica
authors.affiliation: Department of Digestive Surgery, University Hospital of Saint-Louis, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Cattan
authors.affiliation: Department of Digestive Surgery, University Hospital of Saint-Louis, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Munoz-Bongrand
authors.affiliation: Department of Gastroenterology, University Hospital of Saint-Louis, Paris, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Gornet
authors.affiliation: Department of Gastroenterology, University Hospital of Saint-Louis, Paris, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Allez
mesh_terms: D000293:Adolescent; D000328:Adult; D003106:Colon / Q000601:surgery; D003113:Colonoscopy; D003424:Crohn Disease / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D012007:Rectum / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents
keywords: Crohn's disease; Ileocolonoscopy; Post-operative recurrence; Prevention