Clinical utility of a new endoscopic scoring system for Crohn's disease

Kazuhiro Morise, Takafumi Ando, Osamu Watanabe, Masanao Nakamura, Ryoji Miyahara, Osamu Maeda, Kazuhiro Ishiguro, Yoshiki Hirooka, Hidemi Goto

研究成果: ジャーナルへの寄稿総説査読

11 被引用数 (Scopus)

抄録

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.

本文言語英語
ページ(範囲)9974-9981
ページ数8
ジャーナルWorld Journal of Gastroenterology
21
34
DOI
出版ステータス出版済み - 14-09-2015
外部発表はい

All Science Journal Classification (ASJC) codes

  • 消化器病学

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