title: Ileal or Anastomotic Location of Lesions Does Not Impact Rate of Postoperative Recurrence in Crohn's Disease Patients Classified i2 on the Rutgeerts Score.
abstract: The Rutgeerts score with 5 grades of severity (i0-i4) is a suitable endoscopic model to predict clinical recurrence following ileocolonic resection in Crohn's disease (CD). Definition of grade i2 includes lesions confined to the ileocolonic anastomosis (i2a) or moderate lesions on the neo-terminal ileum (i2b). The aim of the present study was to evaluate the probability of clinical recurrence in i2a and i2b patients.
  
  
  
  This multicenter retrospective study included all CD patients classified i2 at the first postoperative ileocolonoscopy. The primary outcome was to evaluate the probability of clinical recurrence in patients classified i2a and i2b. The secondary outcome was to compare the rate of global recurrence of CD.
  
  
  
  Fifty patients were included: 23 were classified i2a and 27 were classified i2b. The median duration of follow-up was 40 (18.0-80.4) months in the i2a group and 53.5 (25.0-69.0) months in the i2b group (p = 0.9). The probability of clinical recurrence was not significantly different between patients classified i2a and i2b (p = 0.64). Median time to clinical recurrence after the first ileocolonoscopy and probability of global CD recurrence were not different between the two groups (p ≥ 0.19).
  
  
  
  The rate of clinical postoperative recurrence is not different in i2a and i2b patients. These results suggest that the same therapeutic strategy should be used in all patients classified i2 on the Rutgeerts score whatever the location of postoperative CD recurrence.
authors.affiliation: Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille 2, Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Bayart
authors.affiliation: Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille 2, Lille, France.
authors.forename: N
authors.initials: N
authors.lastname: Duveau
authors.affiliation: Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille 2, Lille, France.
authors.forename: M
authors.initials: M
authors.lastname: Nachury
authors.affiliation: Digestive Surgery Department, Claude Huriez Hospital, University of Lille 2, Lille, France.|Inserm Unit 995, University of Lille 2, Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Zerbib
authors.affiliation: Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille 2, Lille, France.
authors.forename: R
authors.initials: R
authors.lastname: Gerard
authors.affiliation: Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille 2, Lille, France.
authors.forename: J
authors.initials: J
authors.lastname: Branche
authors.affiliation: Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille 2, Lille, France.
authors.forename: V
authors.initials: V
authors.lastname: Maunoury
authors.affiliation: Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille 2, Lille, France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Wils
authors.affiliation: Hepato-Gastroenterology Department, Valenciennes Hospital, Valenciennes, France.
authors.forename: A
authors.initials: A
authors.lastname: Boruchowicz
authors.affiliation: Hepato-Gastroenterology Department, Valenciennes Hospital, Valenciennes, France.
authors.forename: M
authors.initials: M
authors.lastname: Boualit
authors.affiliation: Hepato-Gastroenterology Department, Seclin Hospital, Seclin, France.
authors.forename: J-E
authors.initials: JE
authors.lastname: Laberenne
authors.affiliation: Hepato-Gastroenterology Department, Seclin Hospital, Seclin, France.
authors.forename: O
authors.initials: O
authors.lastname: Manolache
authors.affiliation: Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille 2, Lille, France.|Inserm Unit 995, University of Lille 2, Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Desreumaux
authors.affiliation: Hepato-Gastroenterology Department, Saint-Eloi Hospital, CHRU, Montpellier, France.
authors.forename: G Pineton
authors.initials: GP
authors.lastname: de Chambrun
authors.affiliation: Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille 2, Lille, France. benjamin.pariente@chru-lille.fr.|Inserm Unit 995, University of Lille 2, Lille, France. benjamin.pariente@chru-lille.fr.
authors.forename: B
authors.initials: B
authors.lastname: Pariente
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D003106:Colon / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D003424:Crohn Disease / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology / Q000601:surgery*; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery*; D008297:Male; D011184:Postoperative Period; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies
keywords: Crohn’s disease; Ileocolonic anastomosis; Ileocolonoscopy; Postoperative recurrence; Rutgeerts score; Therapeutic management