title: Post-operative recurrence of Crohn's disease: A prospective study at 5 years.
abstract: BACKGROUND
  We aimed to prospectively assess whether endoscopic recurrence severity at 1 year in Crohn's disease is predictive of clinical recurrence within 5 years.
  
  
  METHODS
  Clinical recurrence (Crohn's Disease Activity Index>150) was assessed yearly for 5 years in Crohn's disease patients undergoing ileo-colonic resection. At 1 year, recurrence was assessed by colonoscopy (Rutgeerts' score ≥i1 or ≥2i) and small intestine contrast ultrasonography.
  
  
  RESULTS
  40 patients were included (23 males, median age 39 [16-69] years). Clinical recurrence occurred within 5 years in 16 (40%) patients (years 1, 2, 3, 4, 5: 2 [5%]; 10 [25%]; 4 [10%]; 2 [5%]; 4 [10%], respectively). At 1 year, endoscopic recurrence (score≥i1) occurred in 39 (97.5%) patients (score≥i2: 33 [82.5%]). Ultrasound detected lesions compatible with recurrence in 39/40 (97.5%) patients. Endoscopic score at 1 year was correlated with clinical score at 2 years (p=0.007; r=0.41). Endoscopic score at 1 year was higher in patients with (n=10) vs without (n=30) clinical recurrence at 2 years (3 [2-4] vs 2 [0-4]; p=0.003). Higher endoscopic score (>i2) at 1 year was a risk factor for clinical recurrence within 5 years (OR=0.18; 95% CI 0.04-0.71; p=0.008).
  
  
  CONCLUSIONS
  In Crohn's disease, severity of endoscopic recurrence at 1 year remains a predictive marker of clinical recurrence within 5 years. Small intestine contrast ultrasonography is useful for assessing 1-year recurrence.
authors.affiliation: GI Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Onali
authors.affiliation: GI Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Italy.
authors.forename: Emma
authors.initials: E
authors.lastname: Calabrese
authors.affiliation: GI Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Italy.
authors.forename: Carmelina
authors.initials: C
authors.lastname: Petruzziello
authors.affiliation: GI Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Lolli
authors.affiliation: GI Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Ascolani
authors.affiliation: GI Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ruffa
authors.affiliation: Surgical Unit, Department of Surgery, University of Rome "Tor Vergata", Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sica
authors.affiliation: GI Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Department of Statistic, University of Rome "Tor Vergata", Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Chiaramonte
authors.affiliation: GI Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pallone
authors.affiliation: GI Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Italy. Electronic address: biancone@med.uniroma2.it.
authors.forename: Livia
authors.initials: L
authors.lastname: Biancone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003082:Colectomy; D003113:Colonoscopy; D003287:Contrast Media; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011184:Postoperative Period; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D011092:Polyethylene Glycols
keywords: Crohn's disease; Endoscopic recurrence; Ileocolonoscopy; Postoperative recurrence; Small intestine contrast ultrasonography