| Title: |
Durable remission after ileocolic resection for Crohn's disease is achievable in selected patients. Long-term results of a prospective multicentric cohort study of the GETAID Chirurgie. |
| Authors: |
Abdalla, S.; Benoist, S.; Maggiori, L.; Lefèvre, J. H.; Denost, Q.; Cotte, E.; Germain, A.; Beyer-Berjot, L.; Desfourneaux, V.; Rahili, A.; Duffas, J. P.; Pautrat, K.; Denet, C.; Bridoux, V.; Meurette, G.; Faucheron, J. L.; Loriau, J.; Souche, F. R.; Corte, H.; Vicaut, É.; Zerbib, Philippe; Panis, Y.; Brouquet, A. |
| Contributors: |
Université de Lille; Inserm; CHU Lille; AP-HP. Université Paris Saclay; Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286 |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2025 |
| Collection: |
LillOA (Lille Open Archive - Université de Lille) |
| Subject Terms: |
Crohn's disease; ileocolic resection; recurrence; durable remission |
| Description: |
Background and aims Postoperative recurrence requiring medical treatment intensification or redo surgery is common after ileocolic resection (ICR) for Crohn’s disease (CD). This study aimed to identify a subgroup of CD patients for whom ICR could achieve durable remission. Methods This retrospective follow-up study analyzed 592 CD patients who underwent ICR (2013-2015) in a nationwide prospective cohort. Patients with >36 months follow-up were included. Primary outcome was durable remission, defined as the absence of endoscopic recurrence and/or medical treatment intensification. Uni- and multivariate analyses identified predictive factors for durable remission. Results Among 268 included patients, 59% had B2 phenotype, 70% had a first ICR, and 66% had postoperative medical treatment. After a median follow-up of 85 (36-104) months, 52 patients (19%) experienced durable remission, of whom 24 (46%) didn’t require medical treatment and 28 (54%) maintained the same postoperative treatment, including anti-tumor necrosis factor in 15/28 patients (54%). Surgery could stabilize the disease course in 112 patients (41.7%), including 22.4% endoscopic recurrence that didn’t require CD treatment initiation or intensification. Durable remission rate was significantly increased in B1 phenotype vs B2/B3 (n = 7/18;39% vs n = 45/250;18%, P = .030) and in first ICR vs redo ICR (n = 43/184;23% vs n = 9/80;11%, P = .023). In multivariate analysis, B1 phenotype was the only independent predictive factor for durable remission (odds ratio = 3.59, IC 95%, 1.13-11.37, P = .030). Conclusions Surgery for CD achieved durable remission in 20%, rising to 40% in those with a B1 phenotype. These results support surgery as a viable alternative to medical treatment, offering treatment-free durable remission and preserving medical treatment options. ; 19;1 |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
Journal of Crohn's and Colitis; J Crohns Colitis |
| Availability: |
https://lilloa.univ-lille.fr/handle/20.500.12210/129513; https://hdl.handle.net/20.500.12210/129513 |
| Rights: |
info:eu-repo/semantics/closedAccess |
| Accession Number: |
edsbas.2545949D |
| Database: |
BASE |