Risk and significance of endoscopic/radiological evidence of recurrent Crohn's disease - PubMed (original) (raw)
Clinical Trial
. 1997 Dec;113(6):1823-7.
doi: 10.1016/s0016-5085(97)70001-5.
B G Wolff, A H Steinhart, P W Carryer, K O'Rourke, D F Andrews, J E Blair, J R Cangemi, Z Cohen, J B Cullen, R G Chaytor, G R Greenberg, N M Jaffer, K N Jeejeebhoy, R L MacCarty, R L Ready, L H Weiland
Affiliations
- PMID: 9394721
- DOI: 10.1016/s0016-5085(97)70001-5
Clinical Trial
Risk and significance of endoscopic/radiological evidence of recurrent Crohn's disease
R S McLeod et al. Gastroenterology. 1997 Dec.
Abstract
Background & aims: The aim of this study was to determine the risk of endoscopic/radiological recurrence of Crohn's disease postoperatively and the long-term outcome.
Methods: A randomized placebo-controlled trial was performed to determine the effectiveness of mesalamine in preventing recurrent Crohn's disease postoperatively. Patients in the control group were examined endoscopically/radiologically before entry into and annually during the trial. Findings were classified as minimal or severe.
Results: There were 76 patients (49 men and 37 women; mean age, 37.1 +/- 13.2 years). Fifty (61.7%) had terminal ileal resections. Overall, 55 endoscopic/radiological recurrences were observed in 51 patients (67.1%). Expressed actuarially, the recurrence rate was 27.5% at 1 year (95% confidence interval [CI], 15.8%-37.6%), 60.8% at 2 years (95% CI, 46%-71.3%), and 77.3% at 3 years (95% CI, 62.7%-86.3%). Nineteen (37%) were symptomatic and 12 (24%) were initially asymptomatic but later became symptomatic (mean, 13.0 +/- 8.8 months), whereas 20 (39%) remained asymptomatic (mean, 16.9 +/- 17.4 months). Patients with severe endoscopic/radiological disease were significantly more likely to be or become symptomatic than those with minimal disease (23 of 32 vs. 8 of 19, respectively; P = 0.0437).
Conclusions: This study suggests that postoperative endoscopic/radiological recurrences occur later than previously reported. Furthermore, many of these patients, especially with minimal disease, will remain asymptomatic.
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