Crohn's disease(CD) still remains a challenging chronic inflammatory disorder, both for colorectal surgeons and gastroenterologists. The need for recurrent surgery following primary intestinal resection is still c...Crohn's disease(CD) still remains a challenging chronic inflammatory disorder, both for colorectal surgeons and gastroenterologists. The need for recurrent surgery following primary intestinal resection is still considerable, though recent evidence suggested a declining rate of recurrence. Several conflicting surgical parameters have been identified that might impact on the postoperative outcome positively, such as access to the abdomen, anastomotic configuration or type of disease. Additionally, promising results have been achieved with the increased use of immunosuppressive medications in CD. Consequently, the question arises if we are getting better as a result of novel medical and surgical strategies.展开更多
AIM To evaluate frequency and clinical course of incidental adenocarcinoma in patients with stricturing Crohn's disease(CD).METHODS In this study, consecutive patients, who were operated on for stricturing CD betw...AIM To evaluate frequency and clinical course of incidental adenocarcinoma in patients with stricturing Crohn's disease(CD).METHODS In this study, consecutive patients, who were operated on for stricturing CD between 1997-2012, were included at an academic tertiary referral center. Demographic data and clinical course were obtained by an institutional database and individual chart review. Besides baseline characteristics, intraoperative findings and CD related history were also recorded. Colorectal cancer was classified and staged according to the Union for International Cancer Control(UICC).RESULTS During the study period 484 patients underwent resections due to stricturing CD. Incidental adenocarcinoma was histologically confirmed in 6(1.2%) patients(4 males, 2 females). Patients diagnosed with colorectal cancer had a median age of 43(27-66)years and a median history of CD of 16(7-36) years. Malignant lesions were found in the rectum(n = 4, 66.7%), descending colon(n = 1, 16.7%) and ileocolon(n = 1, 16.7%). According to the UICC classification two patients were stages as?Ⅰ(33.3%), whereas the other patients were classified as stage ⅡA(16.7%), stage ⅢB(16.7%), stage ⅢC(16.7%) and stage Ⅳ(16.7%), respectively. After a median follow-up of 2(0.03-8) years only 1 patient is still alive.CONCLUSION The frequency of incidental colorectal cancer in patients, who undergo surgery for stenotic CD, is low but associated with poor prognosis. However, surgeons need to be aware about the possibility of malignancy in stricturing CD, especially if localized in the rectum.展开更多
文摘Crohn's disease(CD) still remains a challenging chronic inflammatory disorder, both for colorectal surgeons and gastroenterologists. The need for recurrent surgery following primary intestinal resection is still considerable, though recent evidence suggested a declining rate of recurrence. Several conflicting surgical parameters have been identified that might impact on the postoperative outcome positively, such as access to the abdomen, anastomotic configuration or type of disease. Additionally, promising results have been achieved with the increased use of immunosuppressive medications in CD. Consequently, the question arises if we are getting better as a result of novel medical and surgical strategies.
文摘AIM To evaluate frequency and clinical course of incidental adenocarcinoma in patients with stricturing Crohn's disease(CD).METHODS In this study, consecutive patients, who were operated on for stricturing CD between 1997-2012, were included at an academic tertiary referral center. Demographic data and clinical course were obtained by an institutional database and individual chart review. Besides baseline characteristics, intraoperative findings and CD related history were also recorded. Colorectal cancer was classified and staged according to the Union for International Cancer Control(UICC).RESULTS During the study period 484 patients underwent resections due to stricturing CD. Incidental adenocarcinoma was histologically confirmed in 6(1.2%) patients(4 males, 2 females). Patients diagnosed with colorectal cancer had a median age of 43(27-66)years and a median history of CD of 16(7-36) years. Malignant lesions were found in the rectum(n = 4, 66.7%), descending colon(n = 1, 16.7%) and ileocolon(n = 1, 16.7%). According to the UICC classification two patients were stages as?Ⅰ(33.3%), whereas the other patients were classified as stage ⅡA(16.7%), stage ⅢB(16.7%), stage ⅢC(16.7%) and stage Ⅳ(16.7%), respectively. After a median follow-up of 2(0.03-8) years only 1 patient is still alive.CONCLUSION The frequency of incidental colorectal cancer in patients, who undergo surgery for stenotic CD, is low but associated with poor prognosis. However, surgeons need to be aware about the possibility of malignancy in stricturing CD, especially if localized in the rectum.
