期刊
LIFE-BASEL
卷 11, 期 7, 页码 -出版社
MDPI
DOI: 10.3390/life11070602
关键词
Crohn's disease; capsule endoscopy; ileo-colonoscopy; post-operative Crohn's disease
Many patients with Crohn's disease require surgical intervention over time despite aggressive medical therapy, commonly leading to disease recurrence. Ileo-colonoscopy and the Rutgeerts score are used for diagnosis and monitoring, but their limitations can be addressed by using wireless capsule endoscopy as a potentially more accurate, less invasive, and less costly alternative.
Despite aggressive medical therapy, many patients with Crohn's disease require surgical intervention over time. After surgical resection, disease recurrence is common. Ileo-colonoscopy and the Rutgeerts score are commonly used for diagnosis and monitoring of post-operative endoscopic recurrence. The latter is the precursor of clinical recurrence and therefore it impacts prognosis and patient management. However, due to the limited length of bowel assessed by ileo-colonoscopy, this procedure can miss out-of-reach, more proximal lesions in the small bowel. This limitation introduces an important uncertainty when evaluating post-operative relapse by ileo-colonoscopy. In addition, the Rutgeerts score 'per se' bears a number of ambiguities. Here we will discuss the pros and cons of ileo-colonoscopy and other imaging studies including wireless capsule endoscopy to diagnose and manage post-operative recurrence of Crohn's disease. A number of studies provide evidence that wireless capsule endoscopy is a potentially more accurate as well as less invasive and less costly alternative to conventional techniques including ileo-colonoscopy.
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