Impact of treatment adjustment on the endoscopic prognosis of postoperative anastomotic lesions in patients with Crohn's disease.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Translational Gastroenterology Pub Date : 2025-05-20 DOI:10.14309/ctg.0000000000000859

Linlin Yin, Chenliang Ding, Yi Li, Lei Cao, Hongfei Tu, Yue Zhu, Luxuan Tan, Bin Zhang, Jianfeng Gong

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引用次数: 0

Abstract

Background: Anastomotic ulcers are common after ileocolonic resection in patients with Crohn's disease (CD). However, the endoscopic prognosis of isolated anastomotic lesions after treatment adjustment remains unclear.

Methods: We retrospectively included CD patients with anastomotic lesions who were referred to our center for ileocolonoscopy between 2020 and 2024. We conducted an initial evaluation of the impact of treatment adjustment on the endoscopic prognosis of anastomotic lesions. Additionally, we analyzed the association between different adjustment strategies and endoscopic outcome.

Results: In total, 199 eligible CD patients with anastomotic lesions were included in our study. Treatment adjustment promoted mucosal healing (multivariable Cox HR: 2.376, 1.400-4.032, p=0.001) and endoscopic improvement (multivariable Cox HR: 2.373, 1.596-3.530, p<0.001). We also found that the endoscopic ulcer improvement of biologics to biologics switching was superior to that of non-treatment adjustment (Cox HR: 2.055, 1.212-3.482, p=0.007). Cox regression analyses further confirmed that non-biologics to biologics switching was associated with better endoscopic mucosal healing(Cox HR: 2.751, 1.494-5.063, p=0.001) and ulcer improvement(Cox HR: 2.154, 1.322-3.509, p=0.002). Regarding patients with insufficient trough levels of biologics, biologic optimization significantly improved endoscopic mucosal healing (Cox HR: 2.854, 1.345-6.053, p=0.006) and endoscopic ulcer improvement (Cox HR: 2.344, 1.288-4.265, p=0.005).

Conclusions: Treatment adjustment contributed to the improvement of endoscopic prognosis in anastomotic lesions patients. Different adjustment strategies (biologics to biologics switching, non-biologics to biologics switching, biologic optimization) similarly resulted in better endoscopic outcome.

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治疗调整对克罗恩病患者术后吻合口病变内镜预后的影响。

背景：克罗恩病（CD）患者回肠结肠切除术后吻合口溃疡很常见。然而，孤立性吻合口病变治疗调整后的内镜预后尚不清楚。方法：我们回顾性地纳入了2020年至2024年间到我们中心进行回肠结肠镜检查的吻合口病变的CD患者。我们对治疗调整对吻合口病变内镜预后的影响进行了初步评估。此外，我们分析了不同调整策略与内镜结果之间的关系。结果：我们共纳入199例吻合口病变的符合条件的CD患者。治疗调整促进了粘膜愈合（多变量Cox HR: 2.376, 1.400-4.032, p=0.001）和内镜改善（多变量Cox HR: 2.373, 1.596-3.530, p）。结论：治疗调整有助于改善吻合口病变患者的内镜预后。不同的调整策略（生物制剂到生物制剂的切换，非生物制剂到生物制剂的切换，生物制剂的优化）同样导致更好的内镜结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.00

自引率

0.00%

发文量

114

审稿时长

16 weeks

期刊介绍： Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.