EARLY SURGERY IN NEWLY DIAGNOSED ILEOCOLIC CROHN'S DISEASE: LONG TERM DISEASE ACTIVITY AND QUALITY OF LIFE.
Imerio Angriman*, Giovanni Bordignon, Mario Gruppo, Cesare Ruffolo, Gaya Spolverato, Salvatore Pucciarelli, Romeo Bardini, Marco Scarpa
Azienda Ospedale Universita Padova, Padova, Veneto, Italy
Background.
Recent randomized controlled trial showed that early surgery for ileocolonic Crohn's disease (CD) lead to a lower recurrence rate and a better long-term outcome. However, few data are available on what happen in real world setting. The aim of the study is to analyze the recurrence rate, disease activity, use of biologics and quality of life in patients who underwent ileocolonic resection for newly diagnosed CD.
Patients and methods.
In our tertiary care center for IBD surgery, 54 consecutive patients who had ileo-colonic resection for CD and at least two years of follow up were selected. In this cross-sectional observational study, these patients were interviewed for disease activity and quality of life assessment. Comparisons between those who had a ileocolonic resection within a 12 months from the diagnosis and those who were operated on later groups were carried out with non-parametric tests. Outcome measures were Cleveland Global Quality of Life (CGQL) questionnaire and the Body Image Questionnaire (BIQ), use of biologics and disease activity that was defined as Harvey-Bradshaw Index (HBI).
Results.
Fifty-four consecutive CD patients undergoing ileocolonic resection were enrolled and called for a telephonic interview. Ten of them had been operated on within twelve months after the diagnosis of CD. The age at surgery was similar in both groups (early surgery: 47 (IQR:25,25-61) years vs late surgery: 47 (IQR: 36,25-58,25). Disease duration before surgery, was 6,5 (IQR: 5,25-7) months in early surgery group vs 130 (IQR: 62,5-198) in late surgery one (p=0.004). Disease activity at follow-up was: HBI=2 (IQR:1-3) in early surgery group vs 4 (IQR: 2-6) in late surgery one (p=0.06). Quality of life at follow up was: CGQL= 24 (IQR: 23-25,5) in early surgery group vs 22 (IQR: 17,5-26) in late surgery one (p=0.05). No difference was observed in the frequency of need of steroids, immunosuppressors, anti-TNF-alpha and anti-diarrhea drugs nor in term of frequency of clinical recurrence.
Conclusions.
In newly diagnosed CD, early resection of the diseased bowel seems to have a positive effect on disease activity and quality of life at follow up. Early removal of diseased bowel seems to lead to a decreased disease activity.
Back to 2023 Abstracts