イタバシ　ミチオ   Itabashi Michio   板橋　道朗    所属   医学部 医学科    職種   特任教授
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Endoscopic Lesions of Postoperative Anastomotic Area in Patients With Crohn's Disease in the Biologic Era: A Japanese Multi-Centre Nationwide Cohort Study
掲載誌名	正式名：Journal of Crohn's & colitis 略　 称：J Crohns Colitis ISSNコード：18764479/18739946
掲載区分	国外
巻・号・頁	17(12),pp.1968-1979
著者・共著者	UEDA Takeshi,KOYAMA Fumikazu,SUGITA Akira,IKEUCHI Hiroki,FUTAMI Kitaro,FUKUSHIMA Kouhei,NEZU Riichiro,IIJIMA Hideki,MIZUSHIMA Tsunekazu,ITABASHI Michio,WATANABE Kazuhiro,HATA Keisuke,SHINAGAWA Takahide,MATSUOKA Katsuyoshi,TAKENAKA Kento,SASAKI Makoto,NAGASHIMA Manabu,YAMAMOTO Hironori,SHONOZAKI Masaru,FUJIYA Mikihiro,KATO Jun,UENO Yoshitaka,TANAKA Shinji,OKITA Yoshiki,HASHIMOTO Yoshinari,KOBAYASHI Taku,KOGANEI Kazutaka,UCHINO Motoi,FUJII Hisao,SUZUKI Yasuo,HISAMATSU Tadakazu
発行年月	2023/12
概要	BACKGROUND AND AIMS:Many patients have endoscopic evidence of recurrent Crohn's disease [CD] at 1 year after intestinal resection. These lesions predict future clinical recurrence. We endoscopically evaluated postoperative anastomotic lesions in CD patients from a large cohort of postoperative CD patients.METHODS:We retrospectively enrolled CD patients who underwent surgical resection between 2008 and 2013 at 19 inflammatory bowel disease [IBD]-specialist institutions. The initial analyses included patients who underwent ileocolonoscopy ~1 year after intestinal resection. Follow-up analyses assessed any changes in the endoscopic findings over time. We evaluated the postoperative endoscopic findings, which were classified into four categories [no lesion, mild, intermediate, severe] at the sites of the anastomotic line and peri-anastomosis.RESULTS:In total, 267 CD patients underwent postoperative ileocolonoscopy. Postoperative anastomotic lesions were widely detected in index ileocolonoscopy [61.0%] and were more frequently detected in follow-up ileocolonoscopy [74.9%]. Endoscopic severity also increased. Patients with intermediate or severe peri-anastomotic or anastomotic line lesions at the index ileocolonoscopy required significantly more interventions, including endoscopic dilatation or surgery, than patients with mild lesions or no lesions.CONCLUSIONS:Frequent anastomotic lesions were observed at the postoperative index ileocolonoscopy. These gradually increased for subsequent ileocolonoscopy, even in the biologic era. Regarding lesions on the anastomotic line, intermediate lesions on the anastomotic line [e.g. irregular or deep ulcers] might be considered recurrent disease, and mild lesions [e.g. linear superficial ulcers] might be considered non-recurrent disease. Prospective studies are needed to resolve this issue, including treatment enhancement.
DOI	10.1093/ecco-jcc/jjad116
PMID	37450892