Intestinal Research

Original Article

Colorectal neoplasia

Clinical characteristics and risk factors related to polyposis recurrence and advanced neoplasm development among patients with non-hereditary colorectal polyposis: Jihun Jang, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim; Intest Res 2023;21(4):510-517. Published online May 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00139

Background/Aims
Patients with more than 10 cumulative polyps might involve a greater genetic risk of colorectal neoplasia development. However, few studies have investigated the risk factors of polyposis recurrence and development of advanced neoplasms among patients with non-hereditary colorectal polyposis.
Methods
This study included patients (n=855) with 10 or more cumulative polyps diagnosed at Severance Hospital from January 2012 to September 2021. Patients with known genetic mutations related to polyposis, known hereditary polyposis syndromes, insufficient information, total colectomy, and less than 3 years of follow-up were excluded. Finally, 169 patients were included for analysis. We collected clinical data, including colonoscopy surveillance results, and performed Cox regression analyses of risk factors for polyposis recurrence and advanced neoplasm development.
Results
The 169 patients were predominantly male (84.02%), with a mean age of 64.19±9.92 years. The mean number of adenomas on index colonoscopy was 15.33±8.47. Multivariable analysis revealed history of cancer except colon cancer (hazard ratio [HR], 2.23; 95% confidence interval [CI], 1.23–4.01), current smoking (HR, 2.39; 95% CI, 1.17–4.87), and detection of many polyps (≥15) on index colonoscopy (HR, 2.05; 95% CI, 1.21–3.50) were significant risk factors for recurrence of polyposis. We found no statistically significant risk factors for advanced neoplasm development during surveillance among our cohort.
Conclusions
The presence of many polyps (≥15) on index colonoscopy, history of cancer except colon cancer, and current smoking state were significant risk factors for polyposis recurrence among patients with non-hereditary colorectal polyposis.

Citations

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Screening and surveillance for hereditary colorectal cancer
Hee Man Kim, Tae Il Kim
Intestinal Research.2024; 22(2): 119. CrossRef

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Statement

IBD

Proposal of novel staging system CNM (Crohn’s primary site, nodes, mesentery) to predict postoperative recurrence of Crohn’s disease: Guduru Venkat Rao, Partha Pal, Anuradha Sekaran, Pradeep Rebala, Manu Tandan, D. Nageshwar Reddy; Intest Res 2023;21(2):196-204. Published online August 8, 2022; DOI: https://doi.org/10.5217/ir.2022.00045

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After oncologic resection, histological grading and staging of the tumor give important prognostic information about the future risk of recurrence and hence influence the subsequent management plan. Several studies and their meta-analysis have shown that various histological features (e.g., microscopic positive resection margins, plexitis, granuloma, mesenteric inflammatory activity) can predict postoperative clinical/endoscopic/surgical recurrence after resection in Crohn’s disease (CD). Inclusion of mesentery in surgical resection specimens has been shown to reduce surgical recurrence after ileocolonic resection in CD. However, there is no uniform histopathological staging system for risk stratification in postoperative CD to systematically predict postoperative recurrence. This is because the prediction to date is based on clinical characteristics (smoking status, disease phenotype, surgical history). Histopathological predictors are still not adopted in routine clinical practice due to the lack of a uniform staging system, heterogeneity of published studies and lack of standardized definition of histological features. In this article, we attempted to incorporate all such histological features in a single histological staging system CNM (Crohn’s primary site [resection margin positivity, plexitis, granuloma, depth of infiltration], nodes [presence of granuloma], mesentery [involved or not]) in surgical resection specimen in CD. The proposed CNM classification would help to enable systematic reporting, design future clinical trials, stratify postoperative recurrence risk and choose appropriate postoperative prophylaxis.

Citations

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Endoscopic Assessment of Postoperative Recurrence in Crohn's Disease
Partha Pal, Duvvuru Nageshwar Reddy, Guduru Venkat Rao
Gastrointestinal Endoscopy Clinics of North America.2024;[Epub] CrossRef

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Original Articles

Miscellaneous

Primary epiploic appendagitis: compared with diverticulitis and focused on obesity and recurrence: Youn I Choi, Hyun Sun Woo, Jun-Won Chung, Young Sup Shim, Kwang An Kwon, Kyoung Oh Kim, Yoon Jae Kim, Dong Kyun Park; Intest Res 2019;17(4):554-560. Published online October 14, 2019; DOI: https://doi.org/10.5217/ir.2018.00148

Abstract PDF PubReader ePub

Background/Aims
There is limited data to compare the clinical characteristics and recurrence rates between left-sided primary epiploic appendagitis (PEA) versus left-sided acute colonic diverticulitis (ACD), and right-sided PEA versus right-sided ACD, respectively.
Methods
We retrospectively reviewed the medical records and radiologic images of the patients who presented with left-sided or right-sided acute abdominal pain and had computer tomography performed at the time of presentation showing radiological signs of PEA or ACD between January 2004 and December 2014. We compared the clinical characteristics of left PEA versus left ACD and right PEA versus right ACD, respectively.
Results
Fifty-six patients (left:right = 27:29) and 308 patients (left:right = 24:284) were diagnosed with symptomatic PEA and ACD, respectively. Left-sided PEA were statistically significantly younger (50.2 ± 15.4 years vs. 62.1 ± 15.8 years, P= 0.009), more obese (body mass index [BMI]: 26.3 ± 2.9 kg/m2 vs. 22.3 ± 3.1 kg/m2 , P< 0.001), and had more tendencies with normal or mildly elevated high-sensitivity C-reactive protein (hsCRP) (1.2 ± 1.3 mg/dL vs. 8.4 ± 7.9 mg/dL, P< 0.001) than patients with left-sided ACD. The discriminative function of age, BMI and CRP between left-sided PEA versus left-sided ACD was 0.71 (cutoff: age ≤ 59 years, sensitivity of 66.7%, specificity of 77.8%), 0.83 (cutoff: BMI > 24.5 kg/m2 , sensitivity of 80.0%, specificity of 80.0%) and 0.80 (cutoff: CRP < 1.8 mg/dL, sensitivity of 72.2%, specificity of 85.7%).
Conclusions
If patients with left lower quadrant abdominal pain are less than 60 years, obese (BMI > 24.5 kg/m2 ) with or without normal to mild elevated CRP levels (CRP < 1.8 mg/dL), it might be necessary for clinicians to suspect the diagnosis of PEA rather than ACD.

Citations

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Diagnosis and treatment of epiploic appendagitis in a Middle Eastern country: An observational retrospective analysis of 156 cases
Ayman El‐Menyar, Syed G. A. Naqvi, Omer Al‐Yahri, Abdelaziz MA Abusal, Abdulwahhab Al‐Shaikhli, Sadia Sajid, Husham Abdelrahman, Ahmad G. Kloub, Muhamed Ibnas, Rifat Latifi, Yasser M. R. Toble, Hassan Al‐Thani
World Journal of Surgery.2024; 48(6): 1363. CrossRef
Epiploic Adipose Tissue (EPAT) in Obese Individuals Promotes Colonic Tumorigenesis: A Novel Model for EPAT-Dependent Colorectal Cancer Progression
Rida Iftikhar, Patricia Snarski, Angelle N. King, Jenisha Ghimire, Emmanuelle Ruiz, Frank Lau, Suzana D. Savkovic
Cancers.2023; 15(3): 977. CrossRef
Recurrencia en pacientes con apendagitis epiploica: un reporte de caso
Mía Alejandra Gómez Corrales, Fabian Andrés Chávez Ecos, Jackeline Alexandra Espinoza Utani, Carlos Alberto Dávila Hernández
Revista colombiana de Gastroenterología.2023; 38(1): 94. CrossRef

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Endoscopy

Efficacy and safety of cold forceps polypectomy utilizing the jumbo cup: a prospective study: Hiroshi Hasegawa, Shigeki Bamba, Kenichiro Takahashi, Masaki Murata, Taketo Otsuka, Hiroshi Matsumoto, Takehide Fujimoto, Rie Osak, Hirotsugu Imaeda, Atsushi Nishida, Hiromitsu Ban, Ayano Sonoda, Osamu Inatomi, Masaya Sasaki, Mitsushige Sugimoto, Akira Andoh; Intest Res 2019;17(2):265-272. Published online November 28, 2018; DOI: https://doi.org/10.5217/ir.2018.00103

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Background/Aims
There are few prospective studies on cold forceps polypectomy (CFP) using jumbo cup forceps. Therefore, we examined patients with diminutive polyps (5 mm or smaller) treated with CFP using jumbo cup forceps to achieve an adenoma-free colon and also assessed the safety of the procedure and the recurrence rate of missed or residual polyp after CFP by performing follow-up colonoscopy 1 year later.
Methods
We included patients with up to 5 adenomas removed at initial colonoscopy and analyzed data from a total of 361 patients with 573 adenomas. One-year follow-up colonoscopy was performed in 165 patients, at which 251 lesions were confirmed.
Results
The one-bite resection rate with CFP was highest for lesions 3 mm or smaller and decreased significantly with increasing lesion size. Post-procedural hemorrhage was observed in 1 of 573 lesions (0.17%). No perforation was noted. The definite recurrence rate was 0.8% (2/251 lesions). The probable recurrence rate, which was defined as recurrence in the same colorectal segment, was 17%. Adenoma-free colon was achieved in 55% of patients at initial resection. Multivariate analysis revealed that achievement of an adenoma-free colon was significantly associated with number of adenomas and years of endoscopic experience.
Conclusions
CFP using jumbo biopsy forceps was safe and showed a high one-bite resection rate for diminutive lesions of 3 mm or smaller. The low definite recurrence rate confirms the reliability of CFP using jumbo biopsy forceps. Number of adenomas and years of endoscopic experience were key factors in achieving an adenoma-free colon.

Citations

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Polypectomy for Diminutive and Small Colorectal Polyps
Melissa Zarandi-Nowroozi, Roupen Djinbachian, Daniel von Renteln
Gastrointestinal Endoscopy Clinics of North America.2022; 32(2): 241. CrossRef
Cold Snare Resection of Colorectal Polyps: Updates and Recent Developments
Roupen Djinbachian, Daniel von Renteln
Current Treatment Options in Gastroenterology.2022; 20(3): 221. CrossRef
Prospective multicenter study of the efficacy and safety of cold forceps polypectomy for ≤ 6-mm non-ampullary duodenal low-grade adenomas
Hiromitsu Kanzaki, Joichiro Horii, Ryuta Takenaka, Hiroyuki Nakagawa, Kazuhiro Matsueda, Takao Tsuzuki, Masahide Kita, Yasushi Yamasaki, Takehiro Tanaka, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Jun Tomoda, Hiroyuki Okada
Endoscopy International Open.2022; 10(06): E712. CrossRef
Endoscopic resection of local recurrences of diminutive polyps by cold forceps polypectomy
Toshio Kuwai, Takuya Yamada, Tatsuya Toyokawa, Tomohiro Kudo, Naoki Esaka, Hajime Ohta, Haruhiro Yamashita, Yasuo Hosoda, Noriko Watanabe, Naohiko Harada
Scandinavian Journal of Gastroenterology.2021; 56(3): 363. CrossRef
How to Approach Small Polyps in Colon: Tips and Tricks
Sultan Mahmood, Enrik John Aguila, Asad ur Rahman, Asim Shuja, Steven Bollipo
Techniques and Innovations in Gastrointestinal Endoscopy.2021; 23(4): 328. CrossRef
Risk factors for incomplete polyp resection during colonoscopy
Weifeng Lao, Pankaj Prasoon, Gaoyang Cao, Lian Tat Tan, Sheng Dai, Giridhar Hanumappa Devadasar, Xuefeng Huang
Laparoscopic, Endoscopic and Robotic Surgery.2021;[Epub] CrossRef
Rates of Incomplete Resection of 1- to 20-mm Colorectal Polyps: A Systematic Review and Meta-Analysis
Roupen Djinbachian, Ryma Iratni, Madeleine Durand, Paola Marques, Daniel von Renteln
Gastroenterology.2020; 159(3): 904. CrossRef
Child-Pugh B or C Cirrhosis Increases the Risk for Bleeding Following Colonoscopic Polypectomy
Hosim Soh, Jaeyoung Chun, Seung Wook Hong, Seona Park, Yun Bin Lee, Hyun Jung Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jong Pil Im, Yoon Jun Kim, Joo Sung Kim, Jung-Hwan Yoon
Gut and Liver.2020; 14(6): 755. CrossRef

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Colorectal neoplasia

Rates of metachronous adenoma after curative resection for left-sided or right-sided colon cancer: Yuk Fai Lam, Wai Kay Seto, Teresa Tong, Ka Shing Cheung, Oswens Lo, Ivan FN Hung, Wai Lun Law, Wai K Leung; Intest Res 2018;16(4):619-627. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00013

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Background/Aims
We determined the rates of metachronous colorectal neoplasm in colorectal cancer (CRC) patients after resection for right (R)-sided or left (L)-sided cancer.
Methods
Consecutive CRC patients who had undergone surgical resection for curative intent in our hospital between 2001 and 2004 were identified. R-sided colonic cancers refer to cancer proximal to splenic flexure whereas L-sided cancers include rectal cancers. Patients were included only if they had a clearing colonoscopy performed either before or within 6 months after the operation. Findings of surveillance colonoscopy performed up to 5 years after colonic resection were included in the analysis.
Results
Eight hundred and sixty-three CRC patients underwent curative surgical resection during the study period. Three hundred and twenty-seven patients (107 R-sided and 220 L-sided) fulfilled the inclusion criteria and had at least 1 postoperative surveillance colonoscopy performed. The proportion of patients who had polyp and adenoma on surveillance colonoscopy was significantly higher among patients with L-sided than R-sided cancers (polyps: 30.9% vs. 19.6%, P=0.03; adenomas: 25.5% vs. 13.1%, P=0.01). The mean number of adenoma per patient on surveillance colonoscopy was also higher for patients with L-sided than R-sided tumors (0.52; 95% confidence interval [CI], 0.37–0.68 vs. 0.22; 95% CI, 0.08–0.35; P<0.01). Multivariate analysis showed that L-sided cancers, age, male gender and longer follow-up were independent predictors of adenoma detection on surveillance colonoscopy.
Conclusions
Patients with Lsided cancer had a higher rate of metachronous polyps and adenoma than those with R-sided cancer on surveillance colonoscopy.

Citations

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The absolute number of small and diminutive adenomas with high-grade dysplasia is substantially higher compared with large adenomas: a retrospective pooled study
Jiancheng Zhang, Huajun Sun, Fei Xiong, Shan Lei, Guanyu Zhou, Xun Xiao, Lin Liu, Pu Wang
Frontiers in Oncology.2024;[Epub] CrossRef
A survey of current practices in post-polypectomy surveillance in Korea
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoo
Intestinal Research.2024; 22(2): 186. CrossRef
Delineation of gastrointestinal tumors biopsies using a fluorescence lifetime imaging optical fiber probe
D. Suraci, E. Baria, L. Tirloni, J. L. Lagarto, S. Buccianti, C. Agostini, S. Pillozzi, L. Antonuzzo, A. Taddei, R. Cicchi
Journal of Biophotonics.2024;[Epub] CrossRef
Risk factors of advanced metachronous neoplasms in surveillance after colon cancer resection
Kwangwoo Nam, Jeong Eun Shin
The Korean Journal of Internal Medicine.2021; 36(2): 305. CrossRef

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Endoscopy

Three-year colonoscopy surveillance after polypectomy in Korea: a Korean Association for the Study of Intestinal Diseases (KASID) multicenter prospective study: Won Seok Choi, Dong Soo Han, Chang Soo Eun, Dong Il Park, Jeong-Sik Byeon, Dong-Hoon Yang, Sung-Ae Jung, Sang Kil Lee, Sung Pil Hong, Cheol Hee Park, Suck-Ho Lee, Jeong-Seon Ji, Sung Jae Shin, Bora Keum, Hyun Soo Kim, Jung Hye Choi, Sin-Ho Jung; Intest Res 2018;16(1):126-133. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.126

Abstract PDF PubReader ePub

Background/Aims

Colonoscopic surveillance is currently recommended after polypectomy owing to the risk of newly developed colonic neoplasia. However, few studies have investigated colonoscopy surveillance in Asia. This multicenter and prospective study was undertaken to assess the incidence of advanced adenoma based on baseline adenoma findings at 3 years after colonoscopic polypectomy.

Methods

A total of 1,323 patients undergoing colonoscopic polypectomy were prospectively assigned to 3-year colonoscopy surveillance at 11 tertiary endoscopic centers. Relative risks for advanced adenoma after 3 years were calculated according to baseline adenoma characteristics.

Results

Among 1,323 patients enrolled, 387 patients (29.3%) were followed up, and the mean follow-up interval was 31.0±9.8 months. The percentage of patients with advanced adenoma on baseline colonoscopy was higher in the surveillance group compared to the non-surveillance group (34.4% vs. 25.7%). Advanced adenoma recurrence was observed in 17 patients (4.4%) at follow-up. The risk of advanced adenoma recurrence was 2 times greater in patients with baseline advanced adenoma than in those with baseline non-advanced adenoma, though the difference was not statistically significant (6.8% [9/133] vs. 3.1% [8/254], P=0.09). Advanced adenoma recurrence was observed only in males and in subjects aged ≥50 years. In contrast, adenoma recurrence was observed in 187 patients (48.3%) at follow-up. Male sex, older age (≥50 years), and multiple adenomas (≥3) at baseline were independent risk factors for adenoma recurrence.

Conclusions

A colonoscopy surveillance interval of 3 years in patients with baseline advanced adenoma can be considered appropriate.

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When should patients take simethicone orally before colonoscopy for avoiding bubbles: A single-blind, randomized controlled study
Woohyuk Jung, Gyu Man Oh, Jae Hyun Kim, Youn Jung Choi, Min Young Son, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park
Medicine.2023; 102(19): e33728. CrossRef
Comparison of the efficacy and safety between oral sulfate tablet and polyethylene glycol for bowel preparation before colonoscopy according to age
Jae Hyun Kim, Yong Eun Park, Tae Oh Kim, Jongha Park, Gyu Man Oh, Won Moon, Seun Ja Park
Medicine.2022; 101(27): e29884. CrossRef
Optimization of the surveillance strategy in patients with colorectal adenomas: A combination of clinical parameters and index colonoscopy findings
Chan Hyuk Park, Yoon Suk Jung, Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn
Journal of Gastroenterology and Hepatology.2021; 36(4): 974. CrossRef
Postgastrectomy gastric cancer patients are at high risk for colorectal neoplasia: a case control study
Tae-Geun Gweon, Kyu-Tae Yoon, Chang Hyun Kim, Jin-Jo Kim
Intestinal Research.2021; 19(2): 239. CrossRef
Risk of developing metachronous advanced colorectal neoplasia after resection of low-risk diminutive versus small adenomas
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
Gastrointestinal Endoscopy.2020; 91(3): 622. CrossRef
Optimal Colonoscopic Surveillance Interval After Normal Baseline Screening Colonoscopy
Jian Dong, Minman Wu, Jiarong Miao, Rana Sami Ullah Khan, Tao Zhi, Tianmei Zhang, Xue Li, Yashi Peng, Gang Yang, Qiong Nan
Gastroenterology Nursing.2020; 43(3): 225. CrossRef
Comparative systematic review and meta-analysis of 1- to 5-mm versus 6- to 9-mm adenomas on the risk of metachronous advanced colorectal neoplasia
Yoon Suk Jung, Tae Jun Kim, Eunwoo Nam, Chan Hyuk Park
Gastrointestinal Endoscopy.2020; 92(3): 692. CrossRef
Appropriate Surveillance Interval after Colonoscopic Polypectomy in Patients Younger than 50 Years
Yoon Suk Jung, Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn
Journal of Korean Medical Science.2019;[Epub] CrossRef
Impact of obesity and metabolic abnormalities on the risk of metachronous colorectal neoplasia after polypectomy in men
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
Journal of Gastroenterology and Hepatology.2019; 34(9): 1504. CrossRef
What Is Appropriate Upper Endoscopic Interval Among Dyspeptic Patients With Previously Normal Endoscopy? A Multicenter Study With Bayesian Change Point Analysis
Jong Wook Kim, Kee Wook Jung, Joong Goo Kwon, Jung Bok Lee, Jong Kyu Park, Ki Bae Bang, Chung Hyun Tae, Jung Hwan Oh
Journal of Neurogastroenterology and Motility.2019; 25(4): 544. CrossRef
Risk of Developing Metachronous Advanced Colorectal Neoplasia After Polypectomy in Patients With Multiple Diminutive or Small Adenomas
Nam Hee Kim, Yoon Suk Jung, Mi Yeon Lee, Jung Ho Park, Dong Il Park, Chong Il Sohn
American Journal of Gastroenterology.2019; 114(10): 1657. CrossRef

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Conventional Versus Biological Therapy for Prevention of Postoperative Endoscopic Recurrence in Patients With Crohn's Disease: an International, Multicenter, and Observational Study: Paulo Gustavo Kotze, Antonino Spinelli, Rodolff Nunes da Silva, Ivan Folchini de Barcelos, Fábio Vieira Teixeira, Rogério Saad-Hossne, Idblan Carvalho de Albuquerque, Marcia Olandoski, Lorete Maria da Silva Kotze, Yasuo Suzuki, Akihiro Yamada, Ken Takeuchi, Matteo Sacchi, Takayuki Yamamoto; Intest Res 2015;13(3):259-265. Published online June 9, 2015; DOI: https://doi.org/10.5217/ir.2015.13.3.259

Abstract PDF PubReader

Background/Aims

Postoperative endoscopic recurrence (PER) occurs in nearly 80% of patients 1 year after ileocecal resection in patients with Crohn's disease (CD). Biological agents were more effective in reducing the rates of PER in comparison with conventional therapy, in prospective trials. The aim of this study was to compare the PER rates of biological versus conventional therapy after ileocecal resections in patients with CD in real-world practice.

Methods

The MULTIPER (Multicenter International Postoperative Endoscopic Recurrence) database is a retrospective analysis of PER rates in CD patients after ileocecal resection, from 7 referral centers in 3 different countries. All consecutive patients who underwent ileocecal resections between 2008 and 2012 and in whom colonoscopies had been performed up to 12 months after surgery, were included. Recurrence was defined as Rutgeerts' score ≥i2. The patients were allocated to either biological or conventional therapy after surgery, and PER rates were compared between the groups.

Results

Initially, 231 patients were evaluated, and 63 were excluded. Of the 168 patients in the database, 96 received anti-tumor necrosis factor agents and 72 were treated with conventional therapy after resection. The groups were comparable regarding age, gender, and perianal disease. There was longer disease duration, more previous resections, and more open surgical procedures in patients on biologicals postoperatively. PER was identified in 25/96 (26%) patients on biological therapy and in 24/72 (33.3%) patients on conventional therapy (P=0.310).

Conclusions

In this retrospective observational analysis from an international database, no difference was observed between biological and conventional therapy in preventing PER after ileocecal resections in CD patients.

Citations

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Are the New Biologics Effective in the Management of Postoperative Crohn’s Disease?
Fadi H Mourad, Rami G Maalouf, Roni Aoun, Paulo Gustavo Kotze, Jana G Hashash
Inflammatory Bowel Diseases.2024; 30(3): 459. CrossRef
How Reliable Is Endoscopic Scoring of Postoperative Recurrence in Crohn Disease?: A Systematic Review and Meta-Analysis
Eline M. L. van der Does de Willebois, Vittoria Bellato, Marjolijn Duijvestein, Susan van Dieren, Silvio Danese, Pierpaolo Sileri, Christianne J. Buskens, Andrea Vignali, Willem A. Bemelman
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Trends in Surgical Recurrence Among Pediatric Crohn’s Disease Patients Using Administrative Claims Data
Matthew D Egberg, Xian Zhang, Michael Phillips, Michael D Kappelman
Crohn's & Colitis 360.2023;[Epub] CrossRef
Optimal strategies to prevent recrudescent Crohn's disease after resection
Natália Sousa Freitas Queiroz, Takayuki Yamamoto, Paulo Gustavo Kotze
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Profile of Consecutive Fecal Calprotectin Levels in the Perioperative Period and Its Predictive Capacity for Early Endoscopic Recurrence in Crohn’s Disease
Ruiqing Liu, Zhen Guo, Lei Cao, Zhiming Wang, Jianfeng Gong, Yi Li, Weiming Zhu
Diseases of the Colon & Rectum.2019; 62(3): 318. CrossRef
Efficacy of restarting anti-tumor necrosis factor α agents after surgery in patients with Crohn's disease
Sakiko Hiraoka, Shiho Takashima, Yoshitaka Kondo, Toshihiro Inokuchi, Yuusaku Sugihara, Masahiro Takahara, Seiji Kawano, Keita Harada, Jun Kato, Hiroyuki Okada
Intestinal Research.2018; 16(1): 75. CrossRef
Factors affecting the incidence of early endoscopic recurrence after ileocolonic resection for Crohn's disease: a multicentre observational study
I. F. de Barcelos, P. G. Kotze, A. Spinelli, Y. Suzuki, F. V. Teixeira, I. C. de Albuquerque, R. Saad‐Hossne, L. M. da Silva Kotze, T. Yamamoto
Colorectal Disease.2017;[Epub] CrossRef
Disease Phenotype, Activity and Clinical Course Prediction Based on C-Reactive Protein Levels at Diagnosis in Patients with Crohn’s Disease: Results from the CONNECT Study
Jee Hye Kwon, Jong Pil Im, Byong Duk Ye, Jae Hee Cheon, Hyun Joo Jang, Kang Moon Lee, You Sun Kim, Sang Wook Kim, Young Ho Kim, Geun Am Song, Dong Soo Han, Won Ho Kim, Joo Sung Kim
Gut and Liver.2016; 10(4): 595. CrossRef

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Long-Term Clinical Outcome of Clostridium difficile Infection in Hospitalized Patients: A Single Center Study: Young Seok Doh, You Sun Kim, Hye Jin Jung, Young Il Park, Jin Won Mo, Hyun Sung, Kyung Jin Lee, Young Ki Seo, Jeong Seop Moon, Seong Woo Hong; Intest Res 2014;12(4):299-305. Published online October 27, 2014; DOI: https://doi.org/10.5217/ir.2014.12.4.299

Abstract PDF PubReader ePub

Background/Aims

Antibiotic usage and increasingly aging populations have led to increased incidence of Clostridium difficile infection (CDI) in worldwide. Recent studies in Korea have also reported increasing CDI incidence; however, there have been no reports on the long-term outcomes of CDI. We therefore investigated the long-term clinical outcomes of patients with CDI, including delayed recurrence, associated risk factors and mortality.

Methods

Hospitalized patients diagnosed with CDI at Seoul Paik Hospital between January 2007 and December 2008 were included. Their medical records were retrospectively investigated. 'Delayed recurrence' was defined as a relapse 8 weeks after a successful initial treatment. Multivariate logistic regression analysis was performed to identify risk factors for the delayed recurrence. Kaplan-Meier curves were used to analyze mortality rates.

Results

A total of 120 patients were enrolled; among them, 87 were followed-up for at least 1 year, with a mean follow-up period of 34.1±25.1 months. Delayed recurrence was observed in 17 patients (19.5%), and significant risk factors were age (over 70 years, P=0.049), nasogastric tube insertion (P=0.008), and proton pump inhibitor or H₂-blocker treatments (P=0.028). The 12- and 24-month mortality rates were 24.6% and 32.5%, respectively. No deaths were directly attributed to CDI.

Conclusions

Delayed recurrence of CDI was not rare, occurring in 19.5% of the study population. Although CDI-related mortality was not reported, 2-year (32.5%) mortality rate of CDI patients implies that a CDI diagnosis may predict severe morbidity and poor prognosis of the underlying disease.

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Tessel M. van Rossen, Yvette H. van Beurden, Johannes A. Bogaards, Andries E. Budding, Chris J.J. Mulder, Christina M.J.E. Vandenbroucke-Grauls
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Vlad A. Ionescu, Camelia C. Diaconu, Raluca S. Costache, Florentina Gheorghe, Andreea G. Andronesi, Gina Gheorghe
Romanian Journal of Military Medicine.2023; 126(4): 492. CrossRef
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Daira Rubio-Mendoza, Adrián Martínez-Meléndez, Héctor Jesús Maldonado-Garza, Carlos Córdova-Fletes, Elvira Garza-González
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Qiaomai Xu, Shumeng Zhang, Jiazheng Quan, Zhengjie Wu, Silan Gu, Yunbo Chen, Beiwen Zheng, Longxian Lv, Lanjuan Li
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Tessel M. van Rossen, Laura J. van Dijk, Martijn W. Heymans, Olaf M. Dekkers, Christina M. J. E. Vandenbroucke-Grauls, Yvette H. van Beurden
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Kuan-Sheng Wu, Ling-Shan Syue, Aristine Cheng, Ting-Yu Yen, Hsien-Meng Chen, Yu-Hsin Chiu, Yu-Lung Hsu, Chun-Hsiang Chiu, Ting-Yi Su, Wan-Lin Tsai, Wei-Yu Chen, Chung-Hao Huang, Huei-Min Hung, Ling-Ju Huang, Hong-Jie Kuo, Pei-Chin Lin, Ching-Hsiang Yang,
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Fecal Microbiota Transplantation in Recurrent Clostridium Difficile Infection: Is it Superior to Other Conventional Methods?
Zayar Lin, Zafar Iqbal, Juan Fernando Ortiz, Sawleha Arshi Khan, Nusrat Jahan
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Jung Hoon Song, You Sun Kim
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Karn Wijarnpreecha, Suthanya Sornprom, Charat Thongprayoon, Parkpoom Phatharacharukul, Wisit Cheungpasitporn
Journal of Evidence-Based Medicine.2018; 11(1): 40. CrossRef
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Karn Wijarnpreecha, Suthanya Sornprom, Charat Thongprayoon, Parkpoom Phatharacharukul, Wisit Cheungpasitporn, Kiran Nakkala
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Seunghyup Kim, You Sun Kim, Seo Hyun Kim, Dong Hoon Lee, Se Jun Park, Seo Young Yun, Dae Young Kim, Jeonghun Lee, Jeong Seop Moon
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Prediction of Tumor Recurrence in Patients with Non-Gastric Gastrointestinal Stromal Tumors Following Resection according to the Modified National Institutes of Health Criteria: Seung Hyeon Jang, Ji Eun Kwon, Jee Hyun Kim, June Young Lee, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung, Jong Pil Im; Intest Res 2014;12(3):229-235. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.229

Abstract PDF PubReader ePub

Background/Aims

Few studies have investigated the prognosis of non-gastric gastrointestinal stromal tumors (GISTs) under the modified National Institutes of Health (NIH) consensus criteria in Korea. This study aims to clarify the clinical usefulness of the modified NIH criteria for risk stratification.

Methods

From January 2000 through October 2012, 88 patients who underwent curative resection for primary GISTs were included in this study. The enrolled patients were stratified to predict recurrence by the original NIH criteria and modified NIH criteria.

Results

In all, 88 patients had non-gastric GISTs, including 82 and 6 patients with GISTs of the small intestine and colorectum, respectively. The mean age was 57.3±13.0 years, and the median follow-up duration was 3.40 years (range, 0.02-12.76 years). All patients who were placed in the intermediate-risk category according to the original NIH criteria were reclassified into the high-risk category according to the modified NIH criteria. Therefore, the proportion of cases in the intermediate-risk category declined to 0.0% from 25.0% (22/88), and the proportion of cases in the high-risk category increased to 43.2% (38/88) from 18.2% (16/88) under the modified NIH criteria. Among the 22 reclassified patients, 6 (27.3%) suffered a recurrence during the observational period, and the recurrence rate of high-risk category patients was 36.8% (14/38).

Conclusions

Patients in the high-risk category according to the modified NIH criteria had a high GIST recurrence rate. Therefore, the modified NIH criteria are clinically useful in selecting patients who need imatinib adjuvant chemotherapy after curative surgical resection.

Citations

Citations to this article as recorded by

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Jong Soo Lee, So Hyun Park, Seung Joon Choi
Journal of the Korean Society of Radiology.2023; 84(1): 110. CrossRef
Assessment of a Real-world Learning Curve for the Endoscopic Resection of Gastric Gastrointestinal Stromal Tumors
Ying Sun, Luojie Liu, Dongtao Shi, Chao Ma, Xiaodan Xu
Journal of International Medical Research.2023;[Epub] CrossRef
Gastrointestinal Stromal Tumors of the Stomach and Esophagus
Lauren Theiss, Carlo M. Contreras
Surgical Clinics of North America.2019; 99(3): 543. CrossRef
Comparison of Different Risk Classification Systems in 558 Patients with Gastrointestinal Stromal Tumors after R0-Resection
Michael Schmieder, Doris Henne-Bruns, Benjamin Mayer, Uwe Knippschild, Claudia Rolke, Matthias Schwab, Klaus Kramer
Frontiers in Pharmacology.2016;[Epub] CrossRef
A High Risk Group in the Modified National Institutes of Health Consensus Criteria for the Gastrointestinal Stromal Tumor: A Clear Indication of the Adjuvant Imatinib
Dong Kyung Chang
Intestinal Research.2014; 12(3): 176. CrossRef

37,156 View
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Clinical and Endoscopic Recurrence after Surgical Resection in Patients with Crohn's Disease: Yang Woon Lee, Kang-Moon Lee, Woo Chul Chung, Chang Nyol Paik, Hea Jung Sung, You Suk Oh; Intest Res 2014;12(2):117-123. Published online April 29, 2014; DOI: https://doi.org/10.5217/ir.2014.12.2.117

Abstract PDF PubReader

Background/Aims

The natural history of Crohn's disease (CD) is characterized by a remitting and relapsing course and a considerable number of patients ultimately require bowel resection. Moreover, postoperative recurrence is very common. Relatively few studies have investigated the postoperative recurrence of CD in Korea. The aim of the current study was to assess postoperative recurrence rates - both clinical and endoscopic - in CD as well as factors influencing postoperative recurrence.

Methods

Electronic medical records of patients who underwent surgery due to CD were reviewed and analyzed. Patients with incomplete surgical resection, a follow-up period of less than a year, and a history of strictureplasty or perianal surgery were excluded.

Results

Of 112 CD patients, 39 patients had history of bowel resection, and 34 patients met the inclusion criteria. Among them, 26 were male (76%) and the mean age of onset was 32.8 years. The mean follow-up period after operation was 65.4 months. Cumulative clinical recurrence rates were 8.8%, 12.5%, and 33.5% at 12, 24, and 48 months, respectively. Use of immunomodulators for prophylaxis was the only predictor of clinical recurrence in univariate analysis (P=0.042). Of 21 patients who had undergone follow-up colonoscopy after surgery, cumulative endoscopic recurrence rates were 33.3%, 42.9%, and 66.1% at 6, 12, and 24 months, respectively. No significant predicting factor for endoscopic recurrence was detected.

Conclusions

Postoperative recurrence rates in Korean patients with CD are high, and endoscopic recurrence rates are comparable to those reported from Western studies. Appropriate medical prophylaxis seems to be important for preventing postoperative recurrence in CD.

Citations

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Author's Reply
Kang-Moon Lee
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