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Development of a Novel Endoscopic Scoring System to Predict Relapse after Surgery in Intestinal Behçet’s Disease
BACKGROUND/AIMS: The cumulative surgery rate and postoperative relapse of intestinal Behcet’s disease (BD) have been reported to be high. This study aimed to establish a scoring system based on follow-up endoscopic findings that can predict intestinal BD recurrence after surgery. METHODS: Fifty-four...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Editorial Office of Gut and Liver
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254620/ https://www.ncbi.nlm.nih.gov/pubmed/29938457 http://dx.doi.org/10.5009/gnl17547 |
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author | Park, Jung Won Park, Yehyun Park, Soo Jung Kim, Tae Il Kim, Won Ho Cheon, Jae Hee |
author_facet | Park, Jung Won Park, Yehyun Park, Soo Jung Kim, Tae Il Kim, Won Ho Cheon, Jae Hee |
author_sort | Park, Jung Won |
collection | PubMed |
description | BACKGROUND/AIMS: The cumulative surgery rate and postoperative relapse of intestinal Behcet’s disease (BD) have been reported to be high. This study aimed to establish a scoring system based on follow-up endoscopic findings that can predict intestinal BD recurrence after surgery. METHODS: Fifty-four patients with intestinal BD who underwent surgery due to bowel complications and underwent follow-up colonoscopy were retrospectively investigated. Their clinical data, including colonoscopic findings, were retrieved. Classification and regression tree analysis was used to develop an appropriate endoscopic classification model that can explain the postsurgical recurrence of intestinal BD most accurately based on the following classification: e0, no lesions; e1, solitary ulcer <20 mm in size; e2, solitary ulcer ≥ 20 mm in size; and e3, multiple ulcers regardless of size. RESULTS: Clinical relapse occurred in 37 patients (68.5%). Among 38 patients with colonoscopic recurrence, only 29 patients had clinically relapsed. Multivariate analysis identified higher disease activity index for intestinal BD at colonoscopy (hazard ratio [HR], 1.013; 95% confidence interval [CI], 1.005 to 1.021; p=0.002) and colonoscopic recurrence (HR, 2.829; 95% CI, 1.223 to 6.545; p=0.015) as independent risk factors for clinical relapse of intestinal BD. Endoscopic findings were classified into four groups, and multivariate analysis showed that the endoscopic score was an independent risk factor of clinical relapse (p=0.012). The risk of clinical relapse was higher in the e3 group compared to the e0 group (HR, 6.284; 95% CI, 2.036 to 19.391; p=0.001). CONCLUSIONS: This new endoscopic scoring system could predict clinical relapse in patients after surgical resection of intestinal BD. |
format | Online Article Text |
id | pubmed-6254620 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Editorial Office of Gut and Liver |
record_format | MEDLINE/PubMed |
spelling | pubmed-62546202018-11-26 Development of a Novel Endoscopic Scoring System to Predict Relapse after Surgery in Intestinal Behçet’s Disease Park, Jung Won Park, Yehyun Park, Soo Jung Kim, Tae Il Kim, Won Ho Cheon, Jae Hee Gut Liver Original Article BACKGROUND/AIMS: The cumulative surgery rate and postoperative relapse of intestinal Behcet’s disease (BD) have been reported to be high. This study aimed to establish a scoring system based on follow-up endoscopic findings that can predict intestinal BD recurrence after surgery. METHODS: Fifty-four patients with intestinal BD who underwent surgery due to bowel complications and underwent follow-up colonoscopy were retrospectively investigated. Their clinical data, including colonoscopic findings, were retrieved. Classification and regression tree analysis was used to develop an appropriate endoscopic classification model that can explain the postsurgical recurrence of intestinal BD most accurately based on the following classification: e0, no lesions; e1, solitary ulcer <20 mm in size; e2, solitary ulcer ≥ 20 mm in size; and e3, multiple ulcers regardless of size. RESULTS: Clinical relapse occurred in 37 patients (68.5%). Among 38 patients with colonoscopic recurrence, only 29 patients had clinically relapsed. Multivariate analysis identified higher disease activity index for intestinal BD at colonoscopy (hazard ratio [HR], 1.013; 95% confidence interval [CI], 1.005 to 1.021; p=0.002) and colonoscopic recurrence (HR, 2.829; 95% CI, 1.223 to 6.545; p=0.015) as independent risk factors for clinical relapse of intestinal BD. Endoscopic findings were classified into four groups, and multivariate analysis showed that the endoscopic score was an independent risk factor of clinical relapse (p=0.012). The risk of clinical relapse was higher in the e3 group compared to the e0 group (HR, 6.284; 95% CI, 2.036 to 19.391; p=0.001). CONCLUSIONS: This new endoscopic scoring system could predict clinical relapse in patients after surgical resection of intestinal BD. Editorial Office of Gut and Liver 2018-11 2018-09-21 /pmc/articles/PMC6254620/ /pubmed/29938457 http://dx.doi.org/10.5009/gnl17547 Text en Copyright © 2018 by The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Park, Jung Won Park, Yehyun Park, Soo Jung Kim, Tae Il Kim, Won Ho Cheon, Jae Hee Development of a Novel Endoscopic Scoring System to Predict Relapse after Surgery in Intestinal Behçet’s Disease |
title | Development of a Novel Endoscopic Scoring System to Predict Relapse after Surgery in Intestinal Behçet’s Disease |
title_full | Development of a Novel Endoscopic Scoring System to Predict Relapse after Surgery in Intestinal Behçet’s Disease |
title_fullStr | Development of a Novel Endoscopic Scoring System to Predict Relapse after Surgery in Intestinal Behçet’s Disease |
title_full_unstemmed | Development of a Novel Endoscopic Scoring System to Predict Relapse after Surgery in Intestinal Behçet’s Disease |
title_short | Development of a Novel Endoscopic Scoring System to Predict Relapse after Surgery in Intestinal Behçet’s Disease |
title_sort | development of a novel endoscopic scoring system to predict relapse after surgery in intestinal behçet’s disease |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254620/ https://www.ncbi.nlm.nih.gov/pubmed/29938457 http://dx.doi.org/10.5009/gnl17547 |
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