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Artikel ; Online: The Impact of Crohn's Perianal Fistula on Quality of Life: Results of an International Patient Survey.

Spinelli, Antonino / Yanai, Henit / Girardi, Paolo / Milicevic, Slobodan / Carvello, Michele / Maroli, Annalisa / Avedano, Luisa

Crohn's & colitis 360

2023 Band 5, Heft 3, Seite(n) otad036

Abstract: Background: Crohn's perianal fistula is a disabling manifestation of Crohn's disease. However, the additional burden of perianal fistula on patients with only Crohn's disease remains to be addressed. This patient-reported survey considered outcomes of ... ...

Abstract	Background: Crohn's perianal fistula is a disabling manifestation of Crohn's disease. However, the additional burden of perianal fistula on patients with only Crohn's disease remains to be addressed. This patient-reported survey considered outcomes of two domains: "diagnosis" (eg, symptoms) and "living with the disease" (eg, quality of life, well-being, and relationships). Methods: Patients with perianal fistula and Crohn's disease completed an online, self-selective, anonymous, 46-item survey available in 11 languages hosted on the European Federation of Crohn's & Ulcerative Colitis Associations and national patient association websites. The survey was conducted between July and December 2019 in Europe and other regions. Likert scales and closed questions were used to assess outcomes. Results: Of the 820 respondents with Crohn's disease (67.2% women; median age, 40.0 years), 532 (64.9%) reported the presence of perianal fistula. Patients with perianal fistula reported a greater impact on overall quality of life ( Conclusions: Perianal fistulas impact several domains of the life of patients with Crohn's disease. These results may help healthcare practitioners plan therapeutic strategies that address the symptomatic and psychological burden experienced by patients with perianal fistulizing Crohn's disease.
Sprache	Englisch
Erscheinungsdatum	2023-07-25
Erscheinungsland	England
Dokumenttyp	Journal Article
ISSN	2631-827X
ISSN (online)	2631-827X
DOI	10.1093/crocol/otad036
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Single-stapled anastomosis is associated with a lower anastomotic leak rate than double-stapled technique after minimally invasive total mesorectal excision for MRI-defined low rectal cancer.

Foppa, Caterina / Carvello, Michele / Maroli, Annalisa / Sacchi, Matteo / Gramellini, Marco / Montorsi, Marco / Spinelli, Antonino

Surgery

2023 Band 173, Heft 6, Seite(n) 1367–1373

Abstract: Background: After total mesorectal excision, distal rectal transection and anastomosis are critical for short-term, oncological, and functional outcomes, including anastomotic leak. A double-pursestring, single-stapled anastomosis avoids cross-stapling, ...

Abstract	Background: After total mesorectal excision, distal rectal transection and anastomosis are critical for short-term, oncological, and functional outcomes, including anastomotic leak. A double-pursestring, single-stapled anastomosis avoids cross-stapling, overcoming the potential drawbacks of transabdominal rectal transection and double-stapled anastomosis. This study aims to compare the anastomotic leak rate in double-stapled and single-stapled anastomoses after minimally invasive total mesorectal excision for magnetic resonance imaging-defined low rectal cancer. Methods: Adult patients (>18 years old) undergoing minimally invasive total mesorectal excision for magnetic resonance imaging-defined low rectal cancer with a stapled low anastomosis (below 5 centimeters from the anal verge) between January 2010 and January 2022 at a single institution were allocated to 2 groups according to the anastomosis: double-stapled (abdominal stapled transection and double-stapled anastomosis) or single-stapled (transanal rectal transection and double-pursestring single-stapled anastomosis). The exclusion criteria were nonrestorative procedures or any type of manual anastomosis. The primary endpoint was the rate of 90-day clinical and radiologic anastomotic leak. Results: In total, 185 single-stapled and 458 double-stapled were included. Clinical and tumor characteristics were comparable between the groups. The 90-day anastomotic leak rate was significantly lower in the single-stapled group (6.48% vs 15.28%; P = .002), with similar rates of grade and timing. Thirty- and 90-day complication rates were higher in the double-stapled group (P = .0001; P = .02), with comparable Clavien-Dindo grades. At multivariable analysis, double-stapled anastomosis (P = .01), active smoking (P = .03), and the presence of comorbidities (P = .01) resulted as independent risk factors for an anastomotic leak. Conclusion: Transanal transection and double-pursestring, single-stapled anastomosis were associated with a lower anastomotic leak rate after minimally invasive total mesorectal excision for magnetic resonance imaging-defined low rectal cancer.
Mesh-Begriff(e)	Adult ; Humans ; Adolescent ; Anastomotic Leak/epidemiology ; Anastomotic Leak/etiology ; Anastomotic Leak/prevention & control ; Anastomosis, Surgical/adverse effects ; Anastomosis, Surgical/methods ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/surgery ; Rectal Neoplasms/complications ; Rectum/diagnostic imaging ; Rectum/surgery ; Rectum/pathology ; Magnetic Resonance Imaging ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Retrospective Studies
Sprache	Englisch
Erscheinungsdatum	2023-03-24
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2023.02.018
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Transanal transection and single-stapling techniques are associated with shorter rectal cuff and lower urgency rate after pouch surgery compared with the double-stapled approach.

Spinelli, Antonino / Foppa, Caterina / Maroli, Annalisa / Sacchi, Matteo / Armuzzi, Alessandro / Danese, Silvio / Bemelman, Willem / Carvello, Michele

Surgery

2023 Band 174, Heft 4, Seite(n) 808–812

Abstract: Background: Ileal pouch-anal anastomosis is most commonly performed by double-stapling technique after rectal transection with a linear stapler. Double-stapling is increasingly criticized for the uneven longer cuffs and potential weak points. A ... ...

Abstract	Background: Ileal pouch-anal anastomosis is most commonly performed by double-stapling technique after rectal transection with a linear stapler. Double-stapling is increasingly criticized for the uneven longer cuffs and potential weak points. A transanal rectal transection and single-stapled anastomosis may potentially overcome the limitations of double-stapling. A single-stapled anastomosis may be accomplished through a transanal rectal transection followed by bottom-up dissection (transanal-ileal pouch-anal anastomosis) or through an abdominal, rectal dissection and subsequent transanal transection and single-stapled anastomosis. The purpose of this study is to compare short-term and functional outcomes of double-stapling versus single-stapled techniques for ileal pouch-anal anastomosis. Methods: This is a single-institution, ambidirectional study. Patients with ulcerative colitis undergoing ileal pouch-anal anastomosis between 2014 and 2021 were included in the study and allocated into 2 groups: group 1, including double stapled ileal pouch anal anastomosis, and group 2, including single-stapled-ileal pouch-anal anastomosis. The primary endpoint was the difference in functional parameters. Results: A total of 130 patients were included, 46 undergoing double-stapling-ileal pouch-anal anastomosis and 84 receiving single-stapled ileal pouch-anal anastomosis. Rectal-cuff length (defined as the distance between the dentate line and ileal pouch-anal anastomosis) was shorter after single-stapled compared with double-stapling ileal pouch-anal anastomosis (1.98 ± 0.21 vs 2.20 ± 0.53 cm, P = .01). Anastomotic leak rate was comparable between group 1 and group 2 (6% vs 5%, P = .69). Functional parameters were comparable except for urgency, which was lower for single-stapled compared with double-stapling ileal pouch-anal anastomosis (8%, vs 30%, P = .002). Conclusion: Single-stapled ileal pouch-anal anastomosis was associated with a shorter rectal cuff and lower urgency than double-stapling ileal pouch-anal anastomosis. In our opinion, these results warrant a prospective multicentric trial to scrutinize and confirm these benefits on a larger scale.
Mesh-Begriff(e)	Humans ; Prospective Studies ; Treatment Outcome ; Surgical Stapling/methods ; Proctocolectomy, Restorative/adverse effects ; Proctocolectomy, Restorative/methods ; Rectum/surgery ; Anastomosis, Surgical/methods ; Colitis, Ulcerative/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery
Sprache	Englisch
Erscheinungsdatum	2023-07-28
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2023.06.027
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: A Multidisciplinary Approach to Rectal Cancer Treatment in Ulcerative Colitis Results in High Rate of Restorative Minimally Invasive Surgery.

Carvello, Michele / Bellato, Vittoria / Maroli, Annalisa / Hart, Ailsa / Danese, Silvio / Warusavitarne, Janindra / Spinelli, Antonino

Journal of Crohn's & colitis

2021 Band 16, Heft 2, Seite(n) 244–250

Abstract: Background and aims: Few recent studies focus on the treatment of rectal cancer in patients with ulcerative colitis. We report treatment options and results for this subset of patients with a multimodal approach at two European referral centres.: ... ...

Abstract	Background and aims: Few recent studies focus on the treatment of rectal cancer in patients with ulcerative colitis. We report treatment options and results for this subset of patients with a multimodal approach at two European referral centres. Methods: Ulcerative colitis patients diagnosed with rectal cancer arising at less than 15 cm from the anal verge between January 2010 and December 2020 were analysed. Demographics, clinical data, and details of medical and surgical treatment were retrieved from prospectively collected institutional databases. Results: Of 132 patients with ulcerative colitis and concomitant colorectal cancer, rectal cancer was diagnosed in 46. The median time between disease onset and rectal cancer diagnosis was 17.5 years; 21/46 were preoperatively staged as early tumours [cT1-T2/N0]. Eleven patients received neoadjuvant chemoradiotherapy for locally advanced extraperitoneal adenocarcinoma, and the rest underwent surgery first. Over two-thirds of the procedures were restorative [68%]; a minimally invasive approach was used in 96% of patients, with no conversion to open. The median follow-up was 44 months. Local recurrence occurred in three patients [6%]. The cumulative 3-year cancer-specific survival rate was 94% [and the 3-year disease-free rate was 86%]. Conclusions: Rectal cancer in ulcerative colitis is a very complex condition. Our results show that surgery for rectal cancer can be delivered with excellent oncological and functional outcomes in patients with ulcerative colitis. A multidisciplinary discussion among surgeons, gastroenterologists, and medical oncologists is key to ensure the appropriate treatment pathway for individual patients.
Mesh-Begriff(e)	Colitis, Ulcerative/complications ; Colitis, Ulcerative/surgery ; Humans ; Minimally Invasive Surgical Procedures ; Proctocolectomy, Restorative/adverse effects ; Proctocolectomy, Restorative/methods ; Rectal Neoplasms/surgery ; Retrospective Studies ; Treatment Outcome
Sprache	Englisch
Erscheinungsdatum	2021-08-04
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2390120-2
ISSN	1876-4479 ; 1873-9946
ISSN (online)	1876-4479
ISSN	1873-9946
DOI	10.1093/ecco-jcc/jjab139
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Anxiety as a risk factor for postoperative complications after colorectal surgery: new area for perioperative optimization.

Maroli, Annalisa / Carvello, Michele / Foppa, Caterina / Kraft, Miquel / Espín-Basany, Eloy / Pellino, Gianluca / Volpato, Eleonora / Pagnini, Francesco / Spinelli, Antonino

The British journal of surgery

2022 Band 109, Heft 10, Seite(n) 898–899

Mesh-Begriff(e)	Anxiety/etiology ; Colorectal Neoplasms/surgery ; Colorectal Surgery/adverse effects ; Digestive System Surgical Procedures/adverse effects ; Humans ; Perioperative Care/adverse effects ; Postoperative Complications/etiology ; Risk Factors
Sprache	Englisch
Erscheinungsdatum	2022-09-01
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znac162
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Postoperative Complications Are Associated With an Early and Increased Rate of Disease Recurrence After Surgery for Crohn's Disease.

Carvello, Michele / D'Hoore, Andre / Maroli, Annalisa / Cuenca, Carlota / Vermeire, Severine / Danese, Silvio / Bislenghi, Gabriele / Spinelli, Antonino

Diseases of the colon and rectum

2022 Band 66, Heft 5, Seite(n) 691–699

Abstract: Background: Several potential risk factors for Crohn's disease recurrence after surgery have been identified, including age at diagnosis, disease phenotype, and smoking. Despite the clinical relevance, few studies investigated the role of postoperative ... ...

Abstract	Background: Several potential risk factors for Crohn's disease recurrence after surgery have been identified, including age at diagnosis, disease phenotype, and smoking. Despite the clinical relevance, few studies investigated the role of postoperative complications as a possible risk factor for disease recurrence. Objective: To investigate the association between postoperative complications and recurrence in Crohn's disease patients after primary ileocolic resection. Design: This was a retrospective case-control study. Setting: This study was conducted at 2 tertiary academic centers. Patients: We included 262 patients undergoing primary ileocolic resection for Crohn's disease between January 2008 and December 2018 and allocated the patients into recurrent (145) and nonrecurrent (117) groups according to endoscopic findings. Main outcome measures: Postoperative complications were assessed as possible risk factors for endoscopic recurrence after surgery by univariable and multivariable analyses. The effect of postoperative complications on endoscopic and clinical recurrence was evaluated by Kaplan-Meier and Cox regression analyses. Results: On binary logistic regression analysis, smoking (OR = 1.84; 95% CI, 1.02-3.32; p = 0.04), penetrating phenotype (OR = 3.14; 95% CI, 1.58-6.22; p < 0.01), perianal disease (OR = 4.03; 95% CI, 1.75-9.25; p = 0.001), and postoperative complications (OR = 2.23; 95% CI, 1.19-4.17; p = 0.01) were found to be independent risk factors for endoscopic recurrence. Postoperative complications (HR = 1.45; 95% CI, 1.02-2.05; p = 0.03) and penetrating disease (HR = 1.73; 95% CI, 1.24-2.40; p = 0.001) significantly reduced the time to endoscopic recurrence; postoperative complications (HR = 1.6; 95% CI, 1.02-2.88; p = 0.04) and penetrating disease (HR = 207.10; 95% CI, 88.41-542.370; p < 0.0001) significantly shortened the time to clinical recurrence. Limitations: This study was limited by its retrospective design. Conclusions: Postoperative complications are independent risk factors for endoscopic recurrence after primary surgery for Crohn's disease, affecting the rate and timing of endoscopic and clinical disease recurrence. See Video Abstract at http://links.lww.com/DCR/C48 . Las complicaciones posoperatorias estn asociadas con una tasa temprana y aumentada de recurrencia de la enfermedad despus de la ciruga para la enfermedad de crohn: ANTECEDENTES: Se han identificado varios factores de riesgo potenciales para la recurrencia de la enfermedad de Crohn después de la cirugía, incluida la edad en el momento del diagnóstico, el fenotipo de la enfermedad y el tabaquismo. A pesar de la relevancia clínica, pocos estudios investigaron el papel de las complicaciones postoperatorias como posible factor de riesgo para la recurrencia de la enfermedad.OBJETIVO: Investigar la asociación entre las complicaciones postoperatorias y la recurrencia en pacientes con enfermedad de Crohn después de la resección ileocólica primaria.DISEÑO: Este fue un estudio retrospectivo de casos y controles.AJUSTE: Este estudio se realizó en dos centros académicos terciarios.PACIENTES: Incluimos 262 pacientes sometidos a resección ileocólica primaria por enfermedad de Crohn entre Enero de 2008 y Diciembre de 2018 y los asignamos en grupos recurrentes (145) y no recurrentes (117) según los hallazgos endoscópicos.PRINCIPALES MEDIDAS DE RESULTADO: Las complicaciones posoperatorias se evaluaron como posibles factores de riesgo de recurrencia endoscópica después de la cirugía mediante análisis univariable y multivariable. El efecto de las complicaciones posoperatorias sobre la recurrencia endoscópica y clínica se evaluó mediante análisis de regresión de Kaplan-Meier y Cox.RESULTADOS: En el análisis, tabaquismo (OR = 1,84; IC 95%: 1,02-3,32; p = 0,04), fenotipo penetrante (OR = 3,14; IC 95%: 1,58-6,22; p < 0,01), enfermedad perianal (OR = 4,03; IC 95%: 1,75-9,25; p = 0,001) y las complicaciones postoperatorias (OR = 2,23; IC 95%: 1,19-4,17; p = 0,01) fueron factores de riesgo independientes para la recurrencia endoscópica. Las complicaciones posoperatorias (HR = 1,45; IC 95%: 1,02-2,05; p = 0,03) y la enfermedad penetrante (HR = 1,73; IC 95%: 1,24-2,40; p = 0,001) redujeron significativamente el tiempo hasta la recurrencia endoscópica; las complicaciones posoperatorias (HR= 1,6; IC 95%: 1,02-2,88; p = 0,04) y la enfermedad penetrante (HR = 207,10; IC 95%: 88,41-542,37; p < 0,0001) acortaron significativamente el tiempo hasta la recurrencia clínica.LIMITACIONES: Este estudio estuvo limitado por su diseño retrospectivo.CONCLUSIONES: Las complicaciones postoperatorias son factores de riesgo independientes para la recurrencia endoscópica después de la cirugía primaria para la enfermedad de Crohn, lo que afecta la tasa y el momento de la recurrencia endoscópica y clínica de la enfermedad. Consulte el Video Resumen en http://links.lww.com/DCR/C48 . (Traducción-Dr. Yesenia Rojas-Khalil ).
Mesh-Begriff(e)	Humans ; Retrospective Studies ; Case-Control Studies ; Crohn Disease/surgery ; Postoperative Complications ; Intestines/surgery ; Recurrence
Sprache	Englisch
Erscheinungsdatum	2022-10-20
Erscheinungsland	United States
Dokumenttyp	Video-Audio Media ; Journal Article
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000002446
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Routine placement of abdominal drainage in pouch surgery does not impact on surgical outcomes.

Luberto, Antonio / Crippa, Jacopo / Foppa, Caterina / Maroli, Annalisa / Sacchi, Matteo / De Lucia, Francesca / Carvello, Michele / Spinelli, Antonino

Updates in surgery

2022 Band 75, Heft 3, Seite(n) 619–626

Abstract: The evidence does not support the routine use of abdominal drainage (AD) in colorectal surgery. However, there is no data on the usefulness of AD, specifically, after ileal pouch-anal anastomosis (IPAA). The aim of this study is to assess post-operative ... ...

Abstract	The evidence does not support the routine use of abdominal drainage (AD) in colorectal surgery. However, there is no data on the usefulness of AD, specifically, after ileal pouch-anal anastomosis (IPAA). The aim of this study is to assess post-operative outcomes of patients undergoing IPAA with or without AD at a high volume referral center. A retrospective analysis of prospectively collected data of consecutive patients undergoing IPAA with AD (AD group) or without AD (NAD group) was performed. Baseline characteristics, operative, and postoperative data were analyzed and compared between the two groups. A total of 97 patients were included in the analysis, 46 were in AD group and 51 in NAD group. AD group had a higher BMI (23.9 ± 3.9 kg/m
Mesh-Begriff(e)	Humans ; Retrospective Studies ; NAD ; Treatment Outcome ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Anastomosis, Surgical/adverse effects ; Abdominal Wall/surgery ; Drainage/adverse effects ; Colitis, Ulcerative/surgery
Chemische Substanzen	NAD (0U46U6E8UK)
Sprache	Englisch
Erscheinungsdatum	2022-12-07
Erscheinungsland	Italy
Dokumenttyp	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-022-01411-5
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Factors associated with stoma formation in ileocolic resection for Crohn's disease and the development of a predictive scoring system.

Wickramasinghe, Dakshitha / Carvello, Michele / Di Candido, Francesca / Maroli, Annalisa / Adegbola, Samuel / Sahnan, Kapil / Morar, Pritesh / Spinelli, Antonino / Warusavitarne, Janindra

Langenbeck's archives of surgery

2022 Band 407, Heft 7, Seite(n) 2997–3003

Abstract: Purpose: The likelihood of a stoma following ileocolic resection (ICR) for Crohn's disease (CD) is an important consideration. This study aims to identify the factors associated with an increased likelihood of a stoma and develop a predictive scoring ... ...

Abstract	Purpose: The likelihood of a stoma following ileocolic resection (ICR) for Crohn's disease (CD) is an important consideration. This study aims to identify the factors associated with an increased likelihood of a stoma and develop a predictive scoring system (SS). Methods: Patient data were collected from St. Marks Hospital, London, UK and Humanitas Clinical and Research Center, Milan, Italy, on all patients who underwent an ICR for CD from 2005 to 2017. A logistic regression analysis was used for multivariate analysis. The SS was developed from the logistic regression model. The performance of the SS was evaluated using receiver operating characteristics area under the curve (AUROC). Results: A total of 628 surgeries were included in the analysis. Sixty-nine surgeries were excluded due to missing data. The remaining 559 were divided into two cohorts for the scoring system's development (n = 434) and validation (n = 125). The regression model was statistically significant (p < 0.0001). The statistically significant independent variables included sex, preoperative albumin and haemoglobin levels, surgical access and simultaneous colonic resection. The AUROC for the development and validation cohorts were 0.803 and 0.905, respectively (p < 0.0001). Youden's index suggested the cut-off score of - 95.9, with a sensitivity of 87.6% and a specificity of 62.9%. Conclusions: Male sex, low preoperative albumin, anaemia, laparoscopic conversion and simultaneous colonic resection were associated with an increased likelihood of requiring a stoma and were used to develop an SS. The calculator is available online at https://rebrand.ly/CrohnsStoma .
Mesh-Begriff(e)	Humans ; Male ; Crohn Disease/surgery ; Colectomy ; Anastomosis, Surgical ; Colon/surgery ; Albumins ; Retrospective Studies
Chemische Substanzen	Albumins
Sprache	Englisch
Erscheinungsdatum	2022-07-29
Erscheinungsland	Germany
Dokumenttyp	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-022-02626-1
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Early Age of Onset Is an Independent Predictor for a Worse Response to Neoadjuvant Therapies in Sporadic Rectal Cancer Patients.

Foppa, Caterina / Maroli, Annalisa / Luberto, Antonio / La Raja, Carlotta / Spaggiari, Paola / Bonifacio, Cristiana / De Zanet, Stefano / Montorsi, Marco / Piscuoglio, Salvatore / Terracciano, Luigi Maria / Santoro, Armando / Spinelli, Antonino

Cancers

2023 Band 15, Heft 14

Abstract: The incidence of rectal cancer (RC) is increasing in the population aged ≤ 49 (early-onset RC-EORC). EORC patients are more likely to present with locally advanced disease at diagnosis than late-onset RC (LORC; aged ≥ 50) patients. As a consequence, more ...

Abstract	The incidence of rectal cancer (RC) is increasing in the population aged ≤ 49 (early-onset RC-EORC). EORC patients are more likely to present with locally advanced disease at diagnosis than late-onset RC (LORC; aged ≥ 50) patients. As a consequence, more EORC patients undergo neoadjuvant therapies. The response to treatment in EORC patients is still unknown. This study aims to explore the effect of age of onset on the pathological response to neoadjuvant therapies in sporadic locally advanced RC (LARC) patients. Based on an institutional prospectively maintained database, LARC patients undergoing neoadjuvant therapies and radical surgery between January 2010 and December 2022 were allocated to the EORC and LORC groups. The primary endpoint was the rate of incomplete response (Dworak 0-2). A total of 326 LORC and 79 EORC patients were included. Pre-neoadjuvant tumor features were comparable. A significantly higher rate of incomplete response was observed in EORC patients (49% vs. 35%;
Sprache	Englisch
Erscheinungsdatum	2023-07-24
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15143750
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Short and long-term outcomes of surgery for inflammatory (uncomplicated) ileocecal Crohn's disease: Multicentric retrospective analysis of 211 patients.

Avellaneda, Nicolas / Maroli, Annalisa / Tottrup, Anders / Buskens, Christianne / Kotze, Paulo Gustavo / Pellino, Gianluca / Dige, Anders / Haase, Anne-Mette / Haanappel, Anouck / Giorgi, Lorenzo / Carvello, Michelle / Maruyama, Beatriz Yuki / Christensen, Peter / Spinelli, Antonino

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2023 Band 56, Heft 5, Seite(n) 730–736

Abstract: Background: Surgical management for patients with inflammatory ileocecal Crohn's disease (CD) could be a reasonable alternative to second-line medical treatment.: Aim: To assess short and long-term outcomes of patients operated on for inflammatory, ... ...

Abstract	Background: Surgical management for patients with inflammatory ileocecal Crohn's disease (CD) could be a reasonable alternative to second-line medical treatment. Aim: To assess short and long-term outcomes of patients operated on for inflammatory, ileocecal Crohn's disease. Methods: A retrospective analysis of patients intervened at four referral hospitals during 2012-2021 was performed. Results: 211 patients were included. 43% of patients underwent surgery more than 5 years after diagnosis, and 49% had been exposed to at least one biologic agent preoperatively. 89% were operated by laparoscopy, with 1.6% conversion rate. The median length of the resected bowel was 25 cm (7-92) and three patients (1.43%) received a stoma. Median follow-up was 36 (17-70) months. The endoscopic recurrence-free survival proportion at 24, 48, 72, 96, and 120 months was 56%, 52%, 45%, 38%, and 33%, respectively. The clinical recurrence-free survival proportion at 24, 48, 72, 96, and 120 months was 83%, 79%, 76%, 74%, and 74%, respectively. In multivariate analysis, previous biological treatment (HR=2.01; p = 0.001) was associated with a higher risk of overall recurrence. Conclusion: Surgery in patients with primary inflammatory ileocecal CD is associated with good postoperative outcomes, low postoperative morbidity with reasonable recurrence rates.
Mesh-Begriff(e)	Humans ; Crohn Disease/surgery ; Retrospective Studies ; Male ; Female ; Adult ; Middle Aged ; Laparoscopy ; Young Adult ; Adolescent ; Treatment Outcome ; Aged ; Recurrence ; Disease-Free Survival
Sprache	Englisch
Erscheinungsdatum	2023-12-02
Erscheinungsland	Netherlands
Dokumenttyp	Journal Article ; Multicenter Study
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2023.10.017
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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