ABSTRACT

Prevention of Endoscopic Postoperative Recurrence in Crohn's Disease

Rogério Saad-Hossne, Digestive Surgery Unit, UNESP, Botucatu, São Paulo, Brazil
Paulo Gustavo Kotze, Colorectal Surgery Unit, Catholic University of Parana, Curitiba, Brazil
Fábio Teixeira, Digestive Surgery Unit, UNESP, Botucatu, São Paulo; Gastrosaúde Clinics, Marilia. Brazil
Anderson Omar Damião, Gastroenterology Department, University of São Paulo, São Paulo, Brazil

Surgery still has an important role in the treatment of Crohn’s disease, and more than 70% of patients will require surgery at some time in their disease course, even with the best therapeutic options. Unfortunately, these patients have an increased risk of future reoperations in the long term (8-10 years). Recurrence is a common event after surgery and occurs in up to 90% of patients after one year. The natural history of postoperative recurrence of Crohn’s disease demonstrates that endoscopic recurrence precedes clinical symptoms and bowel damage that can lead to future reoperations. Several risk factors are associated with recurrence of Crohn’s disease, mainly smoking, perforating disease, and previous resections. The different strategies of prevention of endoscopic postoperative recurrence lead to better disease control after surgery. In this review the authors describe the risk factors associated with recurrence and debate the therapeutic options for prevention of postoperative endoscopic recurrence.

Keywords: Crohn's disease. Recurrence. Postoperative.

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