{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T16:57:27Z","timestamp":1756573047906,"version":"3.40.4"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,3]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Endoscopy remains the gold standard for evaluating postoperative recurrence in Crohn\u2019s disease. Timely therapy adjustment according to endoscopic findings can improve long-term outcomes.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE:<\/jats:title>\n We aimed to determine the characteristics, clinical values, and safety of the endoscopic evaluation at 1 month after surgery.<\/jats:p>\n <\/jats:sec>\n \n DESIGN:<\/jats:title>\n This was a prospective observational study.<\/jats:p>\n <\/jats:sec>\n \n SETTINGS:<\/jats:title>\n This study was conducted in a tertiary referral hospital.<\/jats:p>\n <\/jats:sec>\n \n PATIENTS:<\/jats:title>\n Patients with Crohn's disease undergoing ileocolic resection between January 2016 and November 2018 were included.<\/jats:p>\n <\/jats:sec>\n \n INTERVENTIONS:<\/jats:title>\n The first postoperative ileocolonoscopy was performed at 4\u20135 weeks after surgery.<\/jats:p>\n <\/jats:sec>\n \n MAIN OUTCOME MEASURES:<\/jats:title>\n The primary outcome was postoperative recurrence within 12 months after surgery. Univariate and multivariate analyses were performed to identify risk factors.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n Among 84 ileocolonoscopies at 4\u20135 weeks, no endoscopic complication occurred. The main endoscopic findings at the first evaluation were anastomotic circumferential ulcers (10, 11.9%), anastomotic scattered ulcers (35, 41.7%), ulcers in the neoterminal ileum (16, 19.0%), edema in anastomosis (50, 59.5%), mild narrowing in anastomosis (7, 8.3%), and mild narrowing in neoterminal ileum (3, 3.6%). Anastomotic scattered ulcers were associated with future postoperative recurrence (OR, 2.532 (95% CI, 1.02\u20136.32), p<\/jats:italic> = 0.046). Fecal calprotectin >150 ug\/g on postoperative day 14 could predict anastomotic scattered ulcers (OR\u201a 2.91 (95% CI, 1.31\u20137.47), p<\/jats:italic> = 0.027). The modified Rutgeerts score was used to define endoscopic findings: i0, 37 (44.0%); i1, 4 (4.8%); i2a, 29 (34.5%); i2b, 11 (13.1%); i3, 0; i4, 3 (3.6%). Score \u2265i2a were associated with future postoperative recurrence (OR, 3.17 (95% CI, 1.22\u20138.27), p<\/jats:italic> = 0.018). No factor was associated with a Rutgeerts score of \u2265i2a at the first endoscopic evaluation.<\/jats:p>\n <\/jats:sec>\n \n LIMITATIONS:<\/jats:title>\n This was a single-center study with a small cohort of patients.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Endoscopic evaluation at 1 month after surgery in CD was safe. Anastomotic scattered ulcers occurred in nearly half of patients and were associated with future postoperative recurrence. See Video Abstract<\/jats:bold> at http:\/\/links.lww.com\/DCR\/B760.<\/jats:p>\n \n LA EVALUACI\u00d3N ENDOSC\u00d3PICA A UN MES DESPU\u00c9S DE LA RESECCI\u00d3N ILEOC\u00d3LICA PARA LA ENFERMEDAD DE CROHN, PREDICE FUTURA RECURRENCIA POSOPERATORIA Y ES SEGURA<\/jats:bold>\n <\/jats:p>\n \n ANTECEDENTES:<\/jats:bold>\n <\/jats:p>\n La endoscopia sigue siendo el est\u00e1ndar de oro para evaluar la recurrencia posoperatoria en la enfermedad de Crohn (EC). El ajuste oportuno en la terapia de acuerdo con los hallazgos endosc\u00f3picos, puede mejorar los resultados a largo plazo.<\/jats:p>\n \n OBJETIVO:<\/jats:bold>\n <\/jats:p>\n Determinar las caracter\u00edsticas, valores cl\u00ednicos y seguridad de la evaluaci\u00f3n endosc\u00f3pica, al mes de la cirug\u00eda.<\/jats:p>\n \n DISE\u00d1O:<\/jats:bold>\n <\/jats:p>\n Estudio observacional prospectivo.<\/jats:p>\n \n ENTORNO CLINICO:<\/jats:bold>\n <\/jats:p>\n El estudio se llev\u00f3 a cabo en un hospital de referencia terciario.<\/jats:p>\n \n PACIENTES:<\/jats:bold>\n <\/jats:p>\n Se incluyeron pacientes con EC sometidos a resecci\u00f3n ileoc\u00f3lica entre enero de 2016 y noviembre de 2018.<\/jats:p>\n \n INTERVENCIONES:<\/jats:bold>\n <\/jats:p>\n La primera ileocolonoscopia posoperatoria se realiz\u00f3 a las 4\u20135 semanas posteriores a la cirug\u00eda.<\/jats:p>\n \n PRINCIPALES MEDIDAS DE RESULTADO:<\/jats:bold>\n <\/jats:p>\n El resultado primario fue la recurrencia posoperatoria dentro de los 12 meses posteriores a la cirug\u00eda. Se realizaron an\u00e1lisis univariados y multivariados para identificar factores de riesgo.<\/jats:p>\n \n RESULTADOS:<\/jats:bold>\n <\/jats:p>\n Entre 84 ileocolonoscopias a las 4-5 semanas, no ocurri\u00f3 ninguna complicaci\u00f3n endosc\u00f3pica. Los principales hallazgos endosc\u00f3picos en la primera evaluaci\u00f3n, fueron \u00falceras anastom\u00f3ticas circunferenciales (10, 11,9%), \u00falceras anastom\u00f3ticas dispersas (35, 41,7%), \u00falceras en el \u00edleon neo-terminal (16, 19,0%), edema en la anastomosis (50, 59,5%), estrechamiento leve en la anastomosis (7, 8,3%) y estrechamiento leve en el \u00edleon neo-terminal (3, 3,6%). Las \u00falceras anastom\u00f3ticas dispersas se asociaron con recurrencia posoperatoria futura (OR, 2,532 (95% CI, 1,02\u20136,32), p<\/jats:italic> = 0,046). La calprotectina fecal en el post d 14 > 150 ug \/ g podr\u00eda predecir \u00falceras anastom\u00f3ticas dispersas (OR\u201a 2,91 (95% CI, 1,31\u20137,47), p<\/jats:italic> = 0,027). Se utiliz\u00f3 la puntuaci\u00f3n de Rutgeerts modificada para definir los hallazgos endosc\u00f3picos: i0, 37 (44,0%); i1, 4 (4,8%); i2a, 29 (34,5%); i2b, 11 (13,1%); i3, 0; i4, 3 (3,6%). La puntuaci\u00f3n \u2265i2a se asoci\u00f3 con recurrencia posoperatoria futura (OR, 3,17 (95% CI, 1,22\u20138,27), p<\/jats:italic> = 0,018). Ning\u00fan factor se asoci\u00f3 con \u2265i2a en la primera endoscopia.<\/jats:p>\n \n LIMITACIONES:<\/jats:bold>\n <\/jats:p>\n Estudio de un solo centro con una peque\u00f1a cohorte de pacientes.<\/jats:p>\n \n CONCLUSIONES:<\/jats:bold>\n <\/jats:p>\n La evaluaci\u00f3n endosc\u00f3pica al mes de la cirug\u00eda en EC, fue segura. Se produjeron \u00falceras anastom\u00f3ticas dispersas en casi la mitad de los pacientes y se asociaron con una futura recurrencia posoperatoria. Consulte Video Resumen<\/jats:bold> en http:\/\/links.lww.com\/DCR\/B760. (Traducci\u00f3n - Dr. Fidel Ruiz Healy<\/jats:italic>)<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/dcr.0000000000002012","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T09:09:39Z","timestamp":1636621779000},"page":"382-389","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Endoscopic Evaluation at 1 Month After Ileocolic Resection for Crohn's Disease Predicts Future Postoperative Recurrence and Is Safe"],"prefix":"10.1097","volume":"65","author":[{"given":"Zhen","family":"Guo","sequence":"first","affiliation":[{"name":"Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. 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China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianfeng","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiming","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. 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