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Article Dans Une Revue Digestive and Liver Disease Année : 2020

Long-term outcome of Crohn's disease patients with upper gastrointestinal stricture: A GETAID study

1 Hôpital Claude Huriez [Lille]
2 Université de Lille
3 EC2M3 - Early detection of Colon Cancer using Molecular Markers and Microbiota (EA 7375)
4 CHU Henri Mondor [Créteil]
5 Service de Gastroentérologie [Hôpital Beaujon]
6 AP-HP - Hopital Saint-Louis [AP-HP]
7 CHU Saint-Antoine [AP-HP]
8 Hôpital Haut-Lévêque [CHU Bordeaux]
9 UB - Université de Bordeaux
10 CHU-Liège - Centre Hospitalier Universitaire de Liège
11 CHU Nantes - Centre Hospitalier Universitaire de Nantes
12 Institut des Maladies de l'Appareil Digestif
13 Hôpital universitaire Robert Debré [Reims]
14 AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)
15 CHU Angers - Centre Hospitalier Universitaire d'Angers
16 CHU Amiens-Picardie
17 PERITOX - Périnatalité et Risques Toxiques - UMR INERIS_I 1
18 Pôle Maladies de l'appareil digestif [CHU Toulouse]
19 UT3 - Université Toulouse III - Paul Sabatier
20 CHU Nice - Centre Hospitalier Universitaire de Nice
21 Service d'Hépato-Gastro-Enterologie et Nutrition [CHU Caen]
22 CH Colmar
23 Hôpital Louis Mourier - AP-HP [Colombes]
24 Université de la Méditerranée - Aix-Marseille 2
25 CIC - Biotherapie - Marseille
26 Hôpital Nord [CHU - APHM]
27 Groupe Hospitalier Intercommunal Le Raincy-Montfermeil
28 CHRU Montpellier - Hôpital Saint Eloi
29 UM - Université de Montpellier
30 CHU UCL Namur
31 Service de Gastro-entérologie et Hépatologie [CHU Saint-Etienne]
32 Centre hospitalier [Valenciennes, Nord]
33 Service d'hépato-gastro-entérologie [Rennes] = Gastroenterology [Rennes]
34 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
35 Service d'Hépato-gastro-entérologie [CHRU Nancy]
36 LIRIC - Lille Inflammation Research International Center - U 995
Philippe Seksik
Laurianne Plastaras
  • Fonction : Auteur

Résumé

Background: There are few data concerning patients with Crohn's disease (CD) complicated by a stricture of the upper gastrointestinal tract (UGT). Aims: We evaluated the outcome and management of CD patients complicated by a stricture of the UGT. Methods: We performed a retrospective multicenter study including all CD patients with a non-passable symptomatic UGT stricture on endoscopy. Primary outcome measure was surgery-free survival from diagnosis of stricture. Efficacy of medical, endoscopic, and surgical treatments, and identification of predictors of surgery were also evaluated. Results: 60 CD patients with an UGT stricture were included. 60% of the strictures were located in the duodenum. With a median follow-up of 5.5 (IQR: 3.0-12.0) years since stricture diagnosis, surgical-free survival was 75% and 64% at 1 and 5 years, respectively. At the end of the follow up, 27 (45%) patients underwent surgery. 77 endoscopic procedures were performed in 30 patients with an immediate success of 81% and a clinical benefit in 84% of the procedures. In multivariate analysis, anti-TNF treatment initiation was associated with a reduced risk of surgery. Conclusion: CD UGT strictures are mainly located in the duodenum. Medical and endoscopic treatments allow to avoid surgery in half of the patients (C) 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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Dates et versions

hal-03228850 , version 1 (24-10-2022)

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Paternité - Pas d'utilisation commerciale

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Thomas Lambin, Aurelien Amiot, Carmen Stefanescu, Jean-Marc M Gornet, Philippe Seksik, et al.. Long-term outcome of Crohn's disease patients with upper gastrointestinal stricture: A GETAID study. Digestive and Liver Disease, 2020, 52 (11), pp.1323-1330. ⟨10.1016/j.dld.2020.08.034⟩. ⟨hal-03228850⟩
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