IMPACT OF THE RUTGEERTS SCORE ON THE MANAGEMENT OF OPERATED CROHN'S DISEASE

Aims The aim of our study is to evaluate the efficacy of the strategy undertaken based on postoperative colonoscopy, and then to identify predictive factors of postoperative recurrence.

Methods This is a prospective analytic study conducted at our department, including 131 patients with operated Crohn's disease out of a total of 651 patients with CD between January 2010 and November 2021. The Rutgeerts score was assessed in all these patients. Multiple linear logistic regression was performed, with a retained significance level of 0.05.

Results Mean age was 42.8±5.4 years with a sex ratio (M/W)=0.7. The main indication for surgery was stenosis in 74 patients(61%). 60 (45%) of patients were put immediately after surgery on Salicylates, 30 (22%)on thiopurine , 16 (12%) remain under no treatment. 91 (69%) had endoscopic recurrence with a score of Rutgeerts i2 in 65 patients (71%), Rutgeerts i3 in 6 patients (6%) and Rutgeerts i4 in 20 patients (21%). After medical adaptation, 41 (31%) progressed to clinical recurrence after a median of 30 months[7-61], and 13(9%) progressed to surgical recurrence after a median of 48 months[23-74]. In multivariate analysis, salicylates and smoking were associated to endoscopic recurrence with (OR=2.3, CI [1.15-4.2],p=0.005) and (OR=1.19 ,CI [1.13-2.19] ,p=0.004)respectively.

Conclusions A therapeutic strategy based on the evaluation of postoperative endoscopic recurrence within one year after surgery allowed in most of our patients to control the disease by adapting the treatment according to the Rutgeerts score

Publication History

Article published online:
14 April 2022