Journal of Crohn's & colitis
Exploration of international differences in preoperative characteristics, indications, postoperative management and endoscopic recurrence rates in patients with Crohn's disease following ileocolic (re-)resection: first outcomes from the IMPACT consortium
By Bak MTJ, Hammoudi N, Lee SH and 8 others.
Abstract
Background
Reports on postoperative outcomes after ileocolic resection (ICR) in Crohn's disease (CD) vary widely. To provide insights into these differences, we compared international data on preoperative characteristics and postoperative management and outcome.
Methods
CD patients undergoing ICR were included from prospective cohort studies in the Netherlands (NL), France (FR), Canada (CAN), and United States of America (USA).
Results
Among 1761 patients, 79% underwent primary resection. In this population, surgery for Montreal classification B1 disease was more common (22% vs 0%-5%) and performed after shorter disease duration (4.3 vs 6.2-7.1 years) in NL than in other cohorts. Active smoking was more prevalent in NL and FR than in CAN and USA (23%-34% vs 7%-13%). In CAN, 54% were biologic-naive versus 27%-36% in other cohorts. Postoperative prophylaxis was prescribed in 28% of patients in NL and CAN, compared with 48% in FR and USA. Ileocolonoscopy within 12 months was performed in 72% in USA versus 88% in other cohorts. In the re-resection population, B1 disease at surgery and disease duration did not differ, whereas other findings were similar. Endoscopic postoperative recurrence (modified Rutgeerts' score ≥ i2b) varied from 36% in FR to 41% in NL, 15% in USA to 24% in CAN after primary resection and from 43% in NL, 46% in FR, 26% in CAN to 29% in USA cohort after re-resection.