TY - JOUR
T1 - Patterns of heal recurrence in crohn's disease
T2 - A prospective randomized study
AU - Cameron, John L.
AU - Hamilton, Stanley R.
AU - Coleman, R. N.Joann
AU - Sitzmann, James V.
AU - Bayless, Theodore M.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 1992
Y1 - 1992
N2 - To gain information on the pathogenesis of ileal recurrence, 86 patients with Crohn's disease undergoing their first ileocolic resection were randomized to receive either an end-to-end (n = 47) or side-to-end (n = 39) anastomosis. The demographic and clinical characteristics of both groups were similar. There were no statistically significant differences between the two groups in postoperative complications or in the subsequent development of symptomatic or documented recurrences. Among the 43 patients with follow-up in the end-to-end anastomosis group, there were 10 documented ileal recurrences (23%), and all involved distal ileum in the characteristic preanastomotic location. Among the 35 patients with follow-up in the side-to-end anastomosis group, there were 11 documented recurrences (31%, not significant). The ileal recurrence pattern could be determined accurately in five of these 11 patients and involved the ileum adjacent to the colon, but spared the distal ileum in the blind pouch. This study suggests that the fecal stream and reflux of colonie contents are important factors in determining the pattern of ileal recurrence after ileocolectomy for Crohn's disease.
AB - To gain information on the pathogenesis of ileal recurrence, 86 patients with Crohn's disease undergoing their first ileocolic resection were randomized to receive either an end-to-end (n = 47) or side-to-end (n = 39) anastomosis. The demographic and clinical characteristics of both groups were similar. There were no statistically significant differences between the two groups in postoperative complications or in the subsequent development of symptomatic or documented recurrences. Among the 43 patients with follow-up in the end-to-end anastomosis group, there were 10 documented ileal recurrences (23%), and all involved distal ileum in the characteristic preanastomotic location. Among the 35 patients with follow-up in the side-to-end anastomosis group, there were 11 documented recurrences (31%, not significant). The ileal recurrence pattern could be determined accurately in five of these 11 patients and involved the ileum adjacent to the colon, but spared the distal ileum in the blind pouch. This study suggests that the fecal stream and reflux of colonie contents are important factors in determining the pattern of ileal recurrence after ileocolectomy for Crohn's disease.
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U2 - 10.1097/00000658-199205000-00018
DO - 10.1097/00000658-199205000-00018
M3 - Article
C2 - 1616391
AN - SCOPUS:0026773084
SN - 0003-4932
VL - 215
SP - 546
EP - 551
JO - Annals of surgery
JF - Annals of surgery
IS - 5
ER -