Brunet T1, Siproudhis L1, Brochard C1, Rabilloud ML2, Bajeux E3, Pagenault M1 and Bouguen G1*
1CHU Pontchaillou, Service des Maladies de l'Appareil Digestif, France
2Centre Hospitalier Bretagne Atlantique, France
3CHU Pontchaillou, Service de Santé Publique, France
Background: Severe Endoscopic Lesions (SEL) during Crohn’s Disease (CD) are usually thought to increase disease complications and the need for surgery but based on a low level of evidence. Aims were to assess disease outcomes of patients with SEL at CD diagnosis on a population-based cohort. Methods: All incident CD cases were prospectively registered from 1994 to 1997 in a limited area of France and charts were reviewed until the last known clinics. SEL was defined by a deep ulceration on at least one intestinal segment. Survival analysis was performed to assess disease outcomes according to SEL at diagnosis on the whole population and restricted to patients with uncomplicated behavior at diagnostic. Results: Among the 272 followed-up patients, 257 (94%) patients were included (exclusion of 15 (6%) patients without colonoscopy at diagnostic). SEL were present at initial colonoscopy for 59 (23%) patients on at least one segment and on two segments for 27 (10%). There was no association between the presence of SEL and the need for surgery (log rank =0.49), the onset of complicated behavior (log rank =0.81) nor hospitalization (log rank =0.95). Looking at the 164 of the 257 (64%) with a complete colonoscopy and a noncomplicated behavior at diagnostic, no association between SEL and each outcome were observed although patients with SEL were more likely treated with immunosuppressant (log rank =0.0028). Conclusion: On a population-based cohort, SEL at diagnosis was not associated with an increased risk of surgery nor Crohn’s disease complications despite for an increased use of IS
Brunet T, Siproudhis L, Brochard C, Rabilloud ML, Bajeux E, Pagenault M, et al. Deep Endoscopic Ulcerations are not Associated with the Need for Surgery or Complicated Behavior: A Population-Based Study. Clin Surg. 2022; 7: 3582..