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Intraoperative enteroscopy detects more lesions but is not predictive of postoperative recurrence in Crohn’s disease

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Abstract

Background

The aim of this investigation was to elucidate the clinical value of intraoperative enteroscopy (IOE) for Crohn’s disease, and to determine the value of IOE in predicting recurrent disease.

Methods

In this study 27 patients requiring surgery were examined by both preoperative radiography and IOE. The findings obtained by these procedures in the remnant small intestine were compared. In 19 patients, the clinical course and colonoscopic or radiographic findings after surgery were analyzed.

Results

Intestinal lesions were identified in 23 patients by IOE, and in 19 patients by radiography. Longitudinal ulcers were equivalently detected by IOE (63%) and radiography (56%), whereas small ulcers and inflammatory polyps were less frequently detected by radiography than by IOE (37% vs 74% and 19% vs 33%, respectively). Neither the presence nor the distribution of IOE findings was related to postoperative recurrence.

Conclusions

Whereas IOE demonstrates small intestinal lesions in detail, the procedure alone cannot predict postoperative recurrence in Crohn’s disease.

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References

  1. Best WR, Becktel JM, Singleton JW (1979) Rederived values of the eight coefficients of the Crohn’s Disease Activity Index (CDAI). Gastroenterology 77: 843–846

    CAS  PubMed  Google Scholar 

  2. Bernstein CN, Boult IF, Greenberg BH, Putten WVD, Duffy G, Grahame GR (1997) A prospective randomized comparison between small bowel enteroclysis and small bowel follow-through in Crohn’s disease. Gastroenterology 113: 390–398

    Article  CAS  PubMed  Google Scholar 

  3. Caprilli R, Corrao G, Taddei G, Tonelli F, Torchio P, Viscido A (1996) Prognostic factors for postoperative recurrence of Crohn’s disease. Dis Colon Rectum 39: 335–341

    Article  CAS  PubMed  Google Scholar 

  4. Chardavoyne R, Flint GW, Pollack S, Wise L (1985) Factors affecting recurrence following resection for Crohn’s disease. Dis Colon Rectum 29: 495–502

    Article  Google Scholar 

  5. Cohen ME, Barkin TS (1989) Enteroscopy and enteroclysis: the combined procedure. Am J Gastroenterol 84: 1413–1415

    CAS  PubMed  Google Scholar 

  6. Greenstein AJ, Lachman P, Sachar DB, Springhorn J, Heimann T, Janowitz DH, Aufses AH (1988) Perforating and nonperforating indications for repeated operations in Crohn’s disease: evidence for two clinical forms. Gut 29: 588–592

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Iida M, Yao T, Ohsato H, Itoh H, Watanabe H (1980) Diagnostic value of intraoperative fiberscopy for small intestinal polyps in familial adenomatosis coli. Endoscopy 12: 161–165

    Article  CAS  PubMed  Google Scholar 

  8. Lautenbach E, Berlin JA, Lichtenstein GR (1998) Risk factors for early postoperative recurrence of Crohn’s disease. Gastroenterology 115: 259–267

    Article  CAS  PubMed  Google Scholar 

  9. Lescut D, Vanco D, Bonnière P, Lecomte-Houcke M, Quandalle P, Wurtz A, Colombel JF, Delmotte JS, Paris JC, Cortot A (1993) Perioperative endoscopy of the whole small bowel in Crohn’s disease. Gut 34: 647–649

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Maglinte DDT, Chernish SM, Kelvin FM, O’Connor KW, Hage JP (1992) Crohn disease of the small intestine: accuracy and relevance of enteroclysis. Radiology 184: 541–545

    Article  CAS  PubMed  Google Scholar 

  11. Nakamura Y, Tani K, Nakamura T, Yao T, Fuyuno S, Koga Y (1974) X-ray examination of the small intestine by means of duodenal intubation [in Japanese]. Stomach Intest 9: 1461–1469

    Google Scholar 

  12. Nordgren SR, Fasth SB, Öresland TO, Hultén LA (1994) Long-term follow-up in Crohn’s disease: mortality, morbidity, and functional status. Scand J Gastroenterol 29: 1122–1128

    Article  CAS  PubMed  Google Scholar 

  13. Pennington L, Hamilton SR, Bayless TM, Cameron JL (1980) Surgical management of Crohn’s disease: influence of disease at margin of resection. Ann Surg 192: 311–318

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Ress AM, Benacci JC, Sarr MG (1992) Efficacy of intraoperative enteroscopy in diagnosis and prevention of recurrent, occult gastrointestinal bleeding. Am J Surg 163: 94–98

    Article  CAS  PubMed  Google Scholar 

  15. Rutgeerts P, Geboes K, Vantrappen G, Kerremans R, Coenegrachts JL, Coremans G (1984) Natural history of recurrent Crohn’s disease at the ileocolonic anastomosis after curative surgery. Gut 25: 665–672

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Sachar DB (1990) The problem of postoperative recurrence of Crohn’s disease. Med Clin North Am 74: 183–188

    CAS  PubMed  Google Scholar 

  17. Smedh K, Olaison G, Nyström PO, Sjödahl R (1993) Intraoperative enteroscopy in Crohn’s disease. Br J Surg 80: 897–900

    Article  CAS  PubMed  Google Scholar 

  18. Sudduth RH, Bute BG, Schoelkopf L, Smith MT, Freeman SR, McNally PR (1992) Small bowel obstruction in a patient with Peutz-Jeghers syndrome: the role of intraoperative endoscopy. Gastrointest Endosc 38: 69–72

    Article  CAS  PubMed  Google Scholar 

  19. Waye JD (1994) Endoscopy of the small bowel: push, sonde and intraoperative. Endoscopy 26: 60–63

    Article  CAS  PubMed  Google Scholar 

  20. Wills JS, Lobis IF, Denstman FJ (1997) Crohn disease: state of art. Radiology 202: 597–610

    Article  CAS  PubMed  Google Scholar 

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Online publication: 3 April 2001

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Esaki, M., Matsumoto, T., Hizawa, K. et al. Intraoperative enteroscopy detects more lesions but is not predictive of postoperative recurrence in Crohn’s disease. Surg Endosc 15, 455–459 (2001). https://doi.org/10.1007/s004640000174

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  • DOI: https://doi.org/10.1007/s004640000174

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