THE TIMING OF POSTOPERATIVE ILEOCOLOSCOPY AND THE SEVERITY OF THE RUTGEERTS SCORE: WHAT IS THE LINK?

Aims Currently, we recommend performing an ileocolonoscopy between 6 and 12 months to assess endoscopic recurrence in Crohn's disease (CD) patients after bowel resection using the Rutgeerts score (RS).The aim of our study was to determine the correlation between a first postoperative ileocoloscopy performed after one year and the severity of the endoscopic recurrence.

Methods This is a retrospective study including all CD patients, over a period of 6 years (January 2011- January 2017), who have had an ileocecal or ileocolic resection. Endoscopic recurrence was assessed by ileocoloscopy, using the RS.

Results We collected 92 patients, with a mean age of 34.72±12.9 years. CD was ileal (34.8%) or ileocolonic (56.5%). The CD behaviour was stricturing in 65.2%, fistulizing in 6.5% and mixed in 28.3% of cases. The main indications for surgery were ileal or ileocecal stenosis (78.3%), internal or external fistula (4.3%), intra-abdominal collection (17.4%). Postoperative colonoscopy was performed before one year in 54.3% of cases (n=50) and beyond one year in 45.7% of cases (n=42). Endoscopic recurrence (SR≥i2) was observed in 56% of patients who had a colonoscopy before 1 year, and in 47.6% for the other group. Endoscopic recurrence was judged to be severe (SR≥i3) in 36% of cases in the first group, and 28.6% in the second without any significant difference between the two groups (p=0.59).

Conclusions According to our study, a first ileocolonoscopy performed after bowel resection surgery, beyond one year, was not significantly associated with more severe endoscopic recurrence.

Publication History

Article published online:
14 April 2022