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International Session(Symposium)7(JSGS・JSGE・JGES)
Sat. November 23rd   10:00 - 12:00   Room 1: Kobe International Exhibition Hall No.2 Building Hall (North)
IS-S7-3_E
Capsule endoscopy is useful for postoperative tight control management in patients with Crohn’s disease
Hisashi Shiga1, Yoichi Kakuta1, Atsushi Masamune1
1Division of Gastroenterology, Tohoku University Graduate School of Medicine
Background: There are insufficient data about the endoscopic activity of small bowel lesions that are common in postoperative patients with Crohn’s disease. We aimed to assess the postoperative activity of small bowel lesions using capsule endoscopy (CE), and to analyze the association between treatment optimization based on postoperative endoscopic activity and the subsequent course.
Methods: In patients who had undergone surgery at our university hospital between December 2013 and February 2016, we prospectively assessed endoscopic activity using CE immediately after surgery and during follow-up. Postoperative medical treatment was optimized based on clinical symptoms or CE findings. We defined the primary outcome as hospitalization or repeat surgery.
Results: Of 37 patients in whom CE was performed immediately after surgery, 33 patients (89.2%) had endoscopic activity. In 22 patients who received follow-up examinations, 16 patients (76.2%) had endoscopic activity. Based on these assessments, 18 patients with high activity on 1st CE or worsening from 1st to 2nd CE received treatment optimization. In the experimental periods (median, 36 months after surgery), 10 patients required hospitalization and five of them received repeat surgery or endoscopic dilation. Patients with treatment optimization based on CE findings had significantly lower rates of primary outcome.
Conclusions: Most patients had endoscopic activity immediately after surgery or during follow-up. Appropriate treatment optimization according to CE findings might improve the postoperative course.
Index Term 1: Crohn’s disease
Index Term 2: Capsule endoscopy
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