Systematic review: Patient‐related, microbial, surgical, and histopathological risk factors for endoscopic post‐operative recurrence in patients with Crohn's disease
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Le résumé fourni par la source
BACKGROUND: Risk stratification for endoscopic post-operative recurrence (ePOR) in Crohn's disease (CD) is required to identify patients who would benefit most from initiation of prophylactic medication and intensive monitoring of recurrence. AIMS: To assess the current evidence on patient-related, microbial, surgical and histopathological risk factors for ePOR in patients with CD after ileocolic (re-)resection. METHODS: Multiple online databases (Embase, MEDLINE, Web of Science and Cochrane Library) were searched up to March 2024. Studies with reported associations of patient-related, microbial, surgical and/or histopathological factors for ePOR (i.e., Rutgeerts' score ≥i2 or modified Rutgeerts' score ≥i2a) were included. The risk of bias was assessed with the Newcastle-Ottawa Scale for observational cohort studies and case-control studies. RESULTS: In total, 47 studies were included (four RCTs, 29 cohort studies, 12 case-control studies, one cross-sectional study and one individual participant data meta-analysis) including 6006 patients (median sample size 87 patients [interquartile range 46-170]). Risk of bias assessment revealed a poor quality in 41% of the studies. An association was reported in multiple studies of ePOR with active smoking at and post-surgery, male sex and prior bowel resection. A heterogeneous association with ePOR was reported for other risk factors included in the current guidelines (penetrating disease, perianal disease, younger age, extensive small bowel disease and presence of granulomas in the resection specimen or myenteric plexitis in the resection margin), and other patient-related, microbial, surgical and histopathological factors. CONCLUSION: Risk factors for ePOR in international guidelines are not consistently reported as risk factors in current literature except for active smoking and prior bowel resection. To develop evidence-based, personalised strategies, large prospective studies are warranted to identify risk factors for ePOR. Validation studies of promising (bio)markers are also required.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Systematic review: Patient‐related, microbial, surgical, and histopathological risk factors for endoscopic post‐operative recurrence in patients with Crohn's disease
- Date Crossref
- 17/06/2024
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Erasmus MC pays non établi dans la noticeÉtablissement de santé
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Maastricht University Research Institute for Nutrition and Translational Research in Metabolism (NUTRIM) pays non établi dans la noticeUniversité ou école supérieure
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Inserm pays non établi dans la noticeOrganisme public
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Université Paris Cité Gastroenterology Department pays non établi dans la noticeUniversité ou école supérieure
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Assistance Publique – Hôpitaux de Paris pays non établi dans la noticeÉtablissement de santé
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Hôpital Saint-Louis pays non établi dans la noticeÉtablissement de santé
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Ecotaxie pays non établi dans la noticeStructure de recherche
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Mount Sinai Hospital pays non établi dans la noticeÉtablissement de santé
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IJsselland Ziekenhuis pays non établi dans la noticeÉtablissement de santé
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Department of Gastroenterology and Hepatology Erasmus University Medical Center Rotterdam Rotterdam the Netherlands pays non établi dans la noticeUniversité ou école supérieure
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Department of Pathology Erasmus University Medical Center Rotterdam Rotterdam the Netherlands pays non établi dans la noticeUniversité ou école supérieure
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Department of Surgery Erasmus University Medical Center Rotterdam Rotterdam the Netherlands pays non établi dans la noticeUniversité ou école supérieure
Erasmus MC, Research Institute for Nutrition and Translational Research in Metabolism (NUTRIM) — Maastricht University et Inserm, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.