Year 2021 / Volume 113 / Number 4
Original
Is the degree of i2a recurrence in Crohn’s disease secondary to ischemic phenomena?

246-250

DOI: 10.17235/reed.2020.6790/2019

Yolanda Zarauza Soto, Cristina Suárez Ferrer, Joaquín Poza Cordón, Eduardo Martín Arranz, Olivia Crivillén Anguita, José Luis Rueda García, María Sanchez Azofra, Laura García Ramírez, María Dolores Martín Arranz,

Abstract
Introduction: the Rutgeerts score is used to assess post-surgical recurrence of Crohn’s disease (CD). The score initially consisted of four grades, with a subsequent sub-classification of grade 2, under which ulcers confined to the anastomosis (i2a) are considered to be of a probable ischemic origin. The aim of this study was to assess whether ulcers confined to the anastomosis appear at the same frequency in patients undergoing surgery for other causes and can therefore be attributed to post-surgical changes. Material and methods: this was a retrospective cohort study with patients who had undergone colonoscopy as per clinical practice between 2017 and 2018. There were two cohorts, one cohort of patients to assess the post-surgical recurrence of CD and another cohort for follow-up after colorectal cancer (CRC) treated with ileocolonic anastomosis. Results: a total of 185 patients were included; 33 % had undergone surgery for CD and 67 % had undergone surgery for CRC. Fifty-six percent of patients were male. Of the patients in the group with ulcers confined to the anastomosis, 75 % had CD and 25 % had been operated on for CRC; the difference was statistically significant (p < 0.0001). In turn, of the patients operated on for CRC, 95 % had no anastomotic lesions compared to 18 % of patients with CD. These differences reached statistical significance (p < 0.0001). Conclusions: In our experience, the occurrence of ulcers on the ileocolonic anastomosis is uncommon in patients that have undergone surgery for CRC, in comparison to patients operated on due to CD. It is possible that these alterations in CD cannot therefore be attributed to solely ischemic or post-surgical phenomena.
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Zarauza Soto Y, Suárez Ferrer C, Poza Cordón J, Martín Arranz E, Crivillén Anguita O, Rueda García J, et all. Is the degree of i2a recurrence in Crohn’s disease secondary to ischemic phenomena?. 6790/2019


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Publication history

Received: 04/12/2019

Accepted: 19/04/2020

Online First: 19/11/2020

Published: 07/04/2021

Article revision time: 124 days

Article Online First time: 351 days

Article editing time: 490 days


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