Evidence map›Paper›PMID 32378095›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2021

Ileocolonic End-to-End Anastomoses in Crohn's Disease Increase the Risk of Early Post-operative Endoscopic Recurrence in Those Undergoing an Emergency Resection.

Lena W Y Thin, Sherman Picardo, Shanela Sooben, Kevin Murray, Jennifer Ryan, Marina H Wallace

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Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Lena W Y ThinDepartment of Gastroenterology, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, Perth, Western Australia, 6150, Australia. Lena.thin@health.wa.gov.au.
Sherman PicardoDepartment of Gastroenterology, Royal Perth Hospital, 197 Wellington St, Perth, WA, 6000, Australia.
Shanela SoobenDepartment of Gastroenterology, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, Perth, Western Australia, 6150, Australia.
Kevin MurraySchool of Population Health, University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6000, Australia.
Jennifer RyanDepartment of Colorectal Surgery, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, Perth, Western Australia, 6150, Australia.
Marina H WallaceSchool of Medicine and Pharmacology, University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6150, Australia.
Fiona Stanley Hospital · AUUniversity of Western Australia · AURoyal Perth Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimSeveral risk factors affecting post-operative recurrence in Crohn's disease patients have been studied, and of these, the role of the anastomosis remains contentious. We aimed to compare the risk of developing early post-operative endoscopic recurrence (EPER), in resections that had an end-to-end anastomosis (ETEA) to a side-to-side anastomosis (STSA).

methodsAll Crohn's disease patients that underwent an ileocolic or small bowel resection between January 2012 and June 2017 at two tertiary IBD centres were reviewed retrospectively. Included patients had a minimum of 12-month clinical follow-up and a colonoscopy within 12 months of the resection or stoma reversal. Univariate and multivariate binary logistic regression analyses determined the independent risk factors for early post-operative endoscopic recurrence, defined as a Rutgeerts score of ≥ i2b.

resultsNinety-two resections associated with an ETEA or a STSA were included for analysis. The ETEA was the most common anastomosis, constructed in 55 patients (59.8%). Forty-nine operations (53.3%) resulted in a ≥ i2b recurrence at the first surveillance colonoscopy. The multivariate analysis showed that there was no difference between the ETEA and STSA in determining the odds ratio (OR) for developing EPER (OR = 2.41 (0.95-6.05), P = 0.06). In those that underwent a resection emergently however, the significant determinants of EPER were as follows: having an ETEA (OR = 38.12 (2.44-595.87), P = 0.01), failing to commence a biologic and/or an immunosuppressant early (OR = 24.21 (1.69, 347.81), P = 0.02), and active smoking (OR = 7.19 (1.12-46.21), P = 0.04).

conclusionThe ETEA is best avoided in those undergoing an emergency resection. The early commencement of a biologic and/or an immunosuppressant and smoking cessation is imperative this high-risk group of patients.

Indexed as

Crohn DiseaseAnastomosis, SurgicalColonColonoscopyHumansIleumRecurrenceRetrospective StudiesAnastomosisCrohn’s diseasePost-operative recurrenceResection

Identifiers

PMID32378095
OpenAlexW3023105654

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.