TY - JOUR
T1 - Clinical utility of a new endoscopic scoring system for Crohn's disease
AU - Morise, Kazuhiro
AU - Ando, Takafumi
AU - Watanabe, Osamu
AU - Nakamura, Masanao
AU - Miyahara, Ryoji
AU - Maeda, Osamu
AU - Ishiguro, Kazuhiro
AU - Hirooka, Yoshiki
AU - Goto, Hidemi
N1 - Publisher Copyright:
© The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved. © 2015 Baishideng Publishing Group Inc. All rights reserved.
PY - 2015/9/14
Y1 - 2015/9/14
N2 - AIM: To evaluate the clinical value of the newly modified Simple Endoscopic Score for Crohn's disease (mSES-CD). METHODS: Seventy-six Crohn's disease (CD) patients who underwent transanal double balloon endoscopy (DBE) in our hospital between 2003 and 2012 were retrospectively reviewed. DBE is defined as small intestinal endoscopy using two attached balloons. We included patients with stenosis which hampered passage of the scope and those who underwent DBE with observation for at least 80 cm from the ileocecal valve. Our new mSES-CD assesses the endoscopic activity of two consecutive small intestinal segments located 0-40 cm and 40-80 cm from the ileocecal valve by DBE, in addition to the activity of four colorectal segments. To compare the usefulness of mSES-CD with SES-CD, we similarly divided the patients into two groups according to total mSES-CD score (low disease activity group, < 4; high disease activity group, ≥ 4). The clinical value of mSES-CD in predicting clinical outcome in patients with CD was evaluated using the occurrence of surgery after DBE as an endpoint. RESULTS: Median age of the 76 CD patients was 36 years (range, 16-71). Thirty-nine patients had stenosis which hampered passage of the DBE to 80 cm on the proximal side from the ileocecal valve. Median evaluable length of small intestine by DBE was 80 cm (range, 3-200). A total of 74 patients had one or more small intestinal lesions detected by DBE, of which 62 (83.8%) were within 80 cm of the ileocecal valve on the proximal side. Only two patients (2.7%) with proximal-side lesions more than 80 cm from the ileocecal valve did not have lesions within 80 cm. Patients with high mSES-CD scores showed significantly shorter surgeryfree survival than those with low scores (P < 0.05). In contrast, surgery-free survival did not significantly differ between the low and high SES-CD groups (P > 0.05). Multivariate analysis by a Cox proportional hazards model identified mSES-CD as an independent factor for surgery-free survival. CONCLUSION: mSES-CD is useful in evaluating the risk of surgery-free survival in patients with CD.
AB - AIM: To evaluate the clinical value of the newly modified Simple Endoscopic Score for Crohn's disease (mSES-CD). METHODS: Seventy-six Crohn's disease (CD) patients who underwent transanal double balloon endoscopy (DBE) in our hospital between 2003 and 2012 were retrospectively reviewed. DBE is defined as small intestinal endoscopy using two attached balloons. We included patients with stenosis which hampered passage of the scope and those who underwent DBE with observation for at least 80 cm from the ileocecal valve. Our new mSES-CD assesses the endoscopic activity of two consecutive small intestinal segments located 0-40 cm and 40-80 cm from the ileocecal valve by DBE, in addition to the activity of four colorectal segments. To compare the usefulness of mSES-CD with SES-CD, we similarly divided the patients into two groups according to total mSES-CD score (low disease activity group, < 4; high disease activity group, ≥ 4). The clinical value of mSES-CD in predicting clinical outcome in patients with CD was evaluated using the occurrence of surgery after DBE as an endpoint. RESULTS: Median age of the 76 CD patients was 36 years (range, 16-71). Thirty-nine patients had stenosis which hampered passage of the DBE to 80 cm on the proximal side from the ileocecal valve. Median evaluable length of small intestine by DBE was 80 cm (range, 3-200). A total of 74 patients had one or more small intestinal lesions detected by DBE, of which 62 (83.8%) were within 80 cm of the ileocecal valve on the proximal side. Only two patients (2.7%) with proximal-side lesions more than 80 cm from the ileocecal valve did not have lesions within 80 cm. Patients with high mSES-CD scores showed significantly shorter surgeryfree survival than those with low scores (P < 0.05). In contrast, surgery-free survival did not significantly differ between the low and high SES-CD groups (P > 0.05). Multivariate analysis by a Cox proportional hazards model identified mSES-CD as an independent factor for surgery-free survival. CONCLUSION: mSES-CD is useful in evaluating the risk of surgery-free survival in patients with CD.
KW - Crohn's disease
KW - Double balloon endoscopy
KW - Modified Simple Endoscopic Score
KW - Mucosal healing
KW - Surgery-free survival
UR - http://www.scopus.com/inward/record.url?scp=84941312413&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84941312413&partnerID=8YFLogxK
U2 - 10.3748/wjg.v21.i34.9974
DO - 10.3748/wjg.v21.i34.9974
M3 - Review article
C2 - 26379402
AN - SCOPUS:84941312413
SN - 1007-9327
VL - 21
SP - 9974
EP - 9981
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
IS - 34
ER -