Pre-operative visceral adipose tissue radiodensity is a potentially novel prognostic biomarker for early endoscopic post-operative recurrence in Crohn’s disease  

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作  者:Phillip Gu Shishir Dube Norman Gellada So Yung Choi Susan Win Yoo Jin Lee Shaohong Yang Talin Haritunians Gil Y Melmed Eric A Vasiliauskas Niru Bonthala Gaurav Syal Andres J Yarur David Ziring Shervin Rabizadeh Phillip Fleshner Cindy Kallman Suzanne Devkota Stephan R Targan Dalin Li Dermot PB McGovern 

机构地区:[1]Department of Medicine,Cedars-Sinai Medical Center,Los Angeles,CA 90048,United States [2]Department of Imaging,Cedars-Sinai Medical Center,Los Angeles,CA 90048,United States [3]Department of Biostatistics Shared Resource,Cedars-Sinai Medical Center,Los Angeles,CA 90048,United States [4]Department of Internal Medicine,Keimyung University School of Medicine,Daegu 42601,South Korea [5]Department of Medicine,University of California at Los Angeles,Los Angeles,CA 90095,United States [6]Department of Medicine,University of California at San Diego,San Diego,CA 92093,United States [7]Department of Pediatrics,Cedars-Sinai Medical Center,Los Angeles,CA 90048,United States [8]Department of Surgery,Cedars-Sinai Medical Center,Los Angeles,CA 90048,United States

出  处:《World Journal of Gastrointestinal Surgery》2024年第3期740-750,共11页世界胃肠外科杂志(英文版)(电子版)

基  金:Supported by American College of Gastroenterology,Clinical Research Award 2022,No.ACG-CR-040-2022;National Institute of Diabetes and Digestive and Kidney Diseases,U01,No.2299170;Helmsley Charitable Trust,No.2352240。

摘  要:BACKGROUND Evidence suggests inflammatory mesenteric fat is involved in post-operative recurrence(POR)of Crohn’s disease(CD).However,its prognostic value is INTRODUCTION Crohn’s disease(CD)is a debilitating chronic immune-mediated inflammatory disease(IMID)of the gastrointestinal tract that is increasing in incidence and prevalence globally[1].CD patients often undergo surgery for disease-related complic-ations and/or medically refractory disease.Unfortunately,surgery is not curative,and many patients develop post-operative recurrence(POR)of CD with a significant proportion eventually requiring additional surgeries.With advances in early detection and therapeutics,the contemporary 10-year risk of surgery has improved from 50%to 26%,but the risk of recurrent surgery has remained unchanged at 30%,suggesting a need to improve post-operative management strategies[2].Presently,there are two accepted strategies to mitigate POR,but each have potential limitations.Firstly,patients start early post-operative pharmacologic prophylaxis within 4-6 wk after surgery.This strategy can potentially overtreat a subset of patient who may not develop long-term disease recurrence off therapy.Consequently,these patients are at risk of medication-related adverse events and the direct and indirect costs associated with therapy with little or no benefit[3].The second strategy is performing early colonoscopy within 6-12 months after surgery and escalating therapy based on FOOTNOTES Author contributions:Gu P is the guarantor of the article and was involved in concept and design,data collection,statistical analysis,drafting of manuscript,and final approval of manuscript;Dube S and Choi SY were involved in statistical analysis,drafting of the manuscript,and final approval of manuscript;Gellada N,Win S,Lee YJ and Yang S were involved in the data collection,drafting of the manuscript,and final approval of manuscript;Haritunians T and Li D were involved in data analysis and interpretation,drafting of manuscript and final approval of manuscr

关 键 词:Crohn’s disease Surgery Visceral adipose tissue Mesenteric adipose tissue Creeping fat Computed tomography 

分 类 号:R735.8[医药卫生—肿瘤]

 

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