Annals of Coloproctology

Original Article

Malignant disease, Rectal cancer,Colorectal cancer,Epidemiology & etiology

Clinicopathological Characteristics and Surgical Outcomes of Crohn Disease-Associated Colorectal Malignancy: Yoo Na Lee, Jong Lyul Lee, Chang Sik Yu, Jong Beom Kim, Seok-Byung Lim, In Ja Park, Young Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Jin Cheon Kim; Ann Coloproctol. 2021;37(2):101-108. Published online April 30, 2021; DOI: https://doi.org/10.3393/ac.2020.11.02

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Purpose
Carcinoma arising from Crohn disease (CD) is rare, and there is no clear guidance on how to properly screen for at-risk patients and choose appropriate care. This study aimed to evaluate the clinicopathological characteristics, treatment, and oncologic outcomes of CD patients diagnosed with colorectal cancer (CRC).
Methods
Using medical records, we retrospectively enrolled a single-center cohort of 823 patients who underwent abdominal surgery for CD between January 2006 and December 2015. CD-associated CRC patients included those with adenocarcinoma, lymphoma, or neuroendocrine tumors of the colon and rectum.
Results
Nineteen patients (2.3%) underwent abdominal surgery to treat CD-associated CRC. The mean duration of CD in the CD-associated CRC group was significantly longer than that in the benign CD group (124.7 ± 77.7 months vs. 68.9 ± 60.2 months, P = 0.006). The CD-associated CRC group included a higher proportion of patients with a history of perianal disease (73.7% vs. 50.2%, P = 0.035) and colonic location (47.4% vs. 6.5%, P = 0.001). Among 19 CD-associated CRC patients, 17 (89.5%) were diagnosed with adenocarcinoma, and of the 17 cases, 15 (88.2%) were rectal adenocarcinoma. On multivariable analyses for developing CRC, only colonic location was a risk factor (relative risk, 7.735; 95% confidence interval, 2.862–20.903; P = 0.001).
Conclusion
Colorectal malignancy is rare among CD patients, even among patients who undergo abdominal surgery. Rectal adenocarcinoma accounted for most of the CRC, and colonic location was a risk factor for developing CRC.

Citations

Citations to this article as recorded by

Perianal Fistulizing Crohn’s Disease–Associated Anorectal and Fistula Cancers: Systematic Review and Expert Consensus
Serre-Yu Wong, Cathy Rowan, Elvira Diaz Brockmans, Cindy C.Y. Law, Elisabeth Giselbrecht, Celina Ang, Sergey Khaitov, David Sachar, Alexandros D. Polydorides, Leon Shin-han Winata, Bram Verstockt, Antonino Spinelli, David T. Rubin, Parakkal Deepak, Dermot
Clinical Gastroenterology and Hepatology.2024;[Epub] CrossRef
Reduced expression of alanyl aminopeptidase is a robust biomarker of non‐familial adenomatous polyposis and non‐hereditary nonpolyposis colorectal cancer syndrome early‐onset colorectal cancer
Ye Jin Ha, Yun Jae Shin, Ka Hee Tak, Jong Lyul Park, Jeong Hwan Kim, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seon Young Kim, Jin Cheon Kim
Cancer Medicine.2023; 12(8): 10091. CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer
Sanghyun An, Hongjin Shim, Kwangmin Kim, Bora Kim, Hui-Jae Bang, Hyejin Do, Hyang-Rae Lee, Youngwan Kim
Annals of Coloproctology.2022; 38(2): 97. CrossRef

Review

Benign GI diease, Inflammatory bowel disease,Benign diesease & IBD

Treatment Strategy for Perianal Fistulas in Crohn Disease Patients: The Surgeon’s Point of View: Jong Lyul Lee, Yong Sik Yoon, Chang Sik Yu; Ann Coloproctol. 2021;37(1):5-15. Published online February 28, 2021; DOI: https://doi.org/10.3393/ac.2021.02.08

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Abstract PDF

Perianal fistula is a frequent complication and one of the subclassifications of Crohn disease (CD). It is the most commonly observed symptomatic condition by colorectal surgeons. Accurately classifying a perianal fistula is the initial step in its management in CD patients. Surgical management is selected based on the type of perianal fistula and the presence of rectal inflammation; it includes fistulotomy, fistulectomy, seton procedure, fistula plug insertion, video-assisted ablation of the fistulous tract, stem cell therapy, and proctectomy with stoma creation. Perianal fistulas are also managed medically, such as antibiotics, immunomodulators, and biologics including anti-tumor necrosis factor-alpha agents. The current standard treatment of choice for perianal fistula in CD patients is the multidisciplinary approach combining surgical and medical management; however, the rate of long-term remission is low and is reported to be 50% at most. Therefore, the optimum management strategy for perianal fistulas associated with CD remains controversial. Currently, the goal of management for CD-related perianal fistulas are controlling symptoms and maintaining long-term anal function without proctectomy, while monitoring progression to anorectal carcinoma. This review evaluates perianal fistula in CD patients and determines the optimal surgical management strategy based on recent evidence.

Citations

Citations to this article as recorded by

Insights into treatment of complex Crohn's perianal fistulas
Gregor Norčič, Nataša Smrekar, Srđan Marković, Goran Barišić, Gediminas Kiudelis, Henrikas Paužas, Tamás Molnár, Attila Szijarto, Zuzana Šerclová, Tina Roblek, Viktor Uršič, Ian White
BMC Proceedings.2024;[Epub] CrossRef
Cell-assisted lipotransfer in treating uncontrollable sepsis associated perianal fistula: a pilot study
In Seob Jeong, Sung Hwan Hwang, Hye Mi Yu, Hyeonseok Jeong
Annals of Coloproctology.2024; 40(2): 169. CrossRef
Management of Perianal Fistulas Associated with Crohn Disease
Kay Greveson, Ola Haj, Ailsa Hart, Parnia Geransar, Oded Zmora
Gastroenterology Nursing.2024;[Epub] CrossRef
Real-World Long-Term Persistence and Surgical Procedure-Free Period Among Bio-naïve Patients with Crohn’s Disease and Fistula Initiated on Ustekinumab
Maryia Zhdanava, Sumesh Kachroo, Porpong Boonmak, Sabree Burbage, Aditi Shah, Patrick Lefebvre, Caroline Kerner, Dominic Pilon
Advances in Therapy.2024; 41(10): 3922. CrossRef
Efficacy and Safety of Upadacitinib for Perianal Fistulizing Crohn’s Disease: A Post Hoc Analysis of 3 Phase 3 Trials
Jean-Frédéric Colombel, Ana P. Lacerda, Peter M. Irving, Remo Panaccione, Walter Reinisch, Florian Rieder, Adam Steinlauf, David Schwartz, Tian Feng, Elena Dubcenco, Samuel I. Anyanwu, F. Stephen Laroux, Colla Cunneen, Nick Powell
Clinical Gastroenterology and Hepatology.2024;[Epub] CrossRef
Optimizing Treatment Outcomes in Crohn’s Disease: A Comprehensive Systematic Review and Meta-Analysis of Regenerative Therapies with Emphasis on Platelet-Rich Plasma
Marcia Carolina Mazzaro, Ana Emília Carvalho de Paula, Livia Bitencourt Pascoal, Livia Moreira Genaro, Isabela Machado Pereira, Bruno Lima Rodrigues, Priscilla de Sene Portel Oliveira, Raquel Franco Leal
Pharmaceuticals.2024; 17(11): 1519. CrossRef
Three‐dimensional modelling as a novel interactive tool for preoperative planning for complex perianal fistulas in Crohn's disease
Sebastián Jeri‐McFarlane, Álvaro García‐Granero, Aina Ochogavía‐Seguí, Gianluca Pellino, Anaí Oseira‐Reigosa, Alejandro Gil‐Catalan, Leandro Brogi, Daniel Ginard‐Vicens, Margarita Gamundi‐Cuesta, Francisco Xavier Gonzalez‐Argente
Colorectal Disease.2023; 25(6): 1279. CrossRef
Risk of anorectal cancer in patients with Crohn's disease and perianal fistula: a nationwide Danish cohort study
Alaa El‐Hussuna, Camilla Engel Lemser, Aske Thorn Iversen, Kristine Højgaard Allin, Tine Jess
Colorectal Disease.2023; 25(7): 1453. CrossRef
The Impact of Crohn’s Perianal Fistula on Quality of Life: Results of an International Patient Survey
Antonino Spinelli, Henit Yanai, Paolo Girardi, Slobodan Milicevic, Michele Carvello, Annalisa Maroli, Luisa Avedano
Crohn's & Colitis 360.2023;[Epub] CrossRef
A Prospective, Single-Arm Study to Evaluate the Safety and Efficacy of RD2-Ver.02, an Autologous Blood Clot, in the Treatment of Anal Fistula
Edward Ram, Yaniv Zager, Dan Carter, Olga Saukhat, Roi Anteby, Ido Nachmany, Nir Horesh
Diseases of the Colon & Rectum.2023;[Epub] CrossRef
Crohn disease
Elizabeth F. Snyder, Stephanie Davis, Kristina Aldrich, Manjakkollai Veerabagu, Tiziana Larussa, Ludovico Abenavoli, Luigi Boccuto
The Nurse Practitioner.2021; 46(12): 22. CrossRef

Original Articles

Benign GI diease, Inflammatory bowel disease

Clinical Characteristics and Postoperative Outcomes of Patients Presenting With Upper Gastrointestinal Tract Crohn Disease: Joon Suk Moon, Jong Lyul Lee, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Hassan Abdullah Alsaleem, Jin Cheon Kim; Ann Coloproctol. 2020;36(4):243-248. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.10.16.1

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Abstract PDF

Purpose
Upper gastrointestinal (GI) tract involvement in Crohn disease (CD) is rare and effectiveness of surgical treatment is limited. The aim of this study was to evaluate characteristics and surgical outcomes of upper GI CD.
Methods
Medical records of 811 patients who underwent intestinal surgery for CD between January 2006 and December 2015 at a single institution were reviewed. Upper GI CD was defined by involvement of the stomach to the fourth portion of duodenum, with or without concomitant small/large bowel CD involvement according to a modification of the Montreal classification.
Results
We identified 24 patients (21 males, 3 females) who underwent surgery for upper GI CD. The mean age at diagnosis was 27 ± 12 years, the mean age at surgery was 33 ± 11 years, and the mean duration of CD was 73.6 ± 56.6 months. Fifteen patients (62.5%) had history of previous perianal surgery. Ten patients (41.7%) had duodenal or gastric stricture and 14 patients (58.3%) had penetrating fistula; patients with fistula were significantly more likely to develop complications (57.1% vs. 20.0%, P = 0.035). One patient with stricture had surgical recurrence. In seven patients with fistula, fistula was related to previous anastomosis. Patients with fistula had significantly longer hospital stays than those with stricture (16 days vs. 11 days, P = 0.01).
Conclusion
Upper GI CD is rare among CD types (2.96%). In patients with upper GI CD, penetrating fistula was associated with longer hospital stay and more complications.

Citations

Citations to this article as recorded by

Update S2k-Guideline Helicobacter pylori and gastroduodenal ulcer disease of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS)
Wolfgang Fischbach, Jan Bornschein, Jörg C. Hoffmann, Sibylle Koletzko, Alexander Link, Lukas Macke, Peter Malfertheiner, Kerstin Schütte, Dieter-Michael Selgrad, Sebastian Suerbaum, Christian Schulz
Zeitschrift für Gastroenterologie.2024; 62(02): 261. CrossRef
Aktualisierte S2k-Leitlinie Helicobacter pylori und gastroduodenale Ulkuskrankheit der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – Juli 2022 – AWMF-Registernummer: 021–001

Zeitschrift für Gastroenterologie.2023; 61(05): 544. CrossRef
A systematic review and meta‐analysis of prevalence and clinical features of upper gastrointestinal (UGI) tract Crohn's disease in adults compared to non‐UGI types
Babak Tamizifar, Peyman Adibi, Maryam Hadipour, Vahid Mohamadi
JGH Open.2023; 7(5): 325. CrossRef
Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents
Eun Sil Kim, Mi Jin Kim
Clinical and Experimental Pediatrics.2022; 65(1): 21. CrossRef
Profiling non-coding RNA levels with clinical classifiers in pediatric Crohn’s disease
Ranjit Pelia, Suresh Venkateswaran, Jason D. Matthews, Yael Haberman, David J. Cutler, Jeffrey S. Hyams, Lee A. Denson, Subra Kugathasan
BMC Medical Genomics.2021;[Epub] CrossRef
Surgical Treatment of Upper Gastrointestinal Tract Crohn Disease: A Long Way to Go to Identify the Optimal Method
Soo Yeun Park
Annals of Coloproctology.2020; 36(4): 207. CrossRef

Benign GI diease, Inflammatory bowel disease

Evaluation of Invasive Intra-abdominal Candidiasis in Crohn Disease at the Time of Surgery: Martin Šašala, Emeše Majorová, Andrej Vrzgula, Iveta Fandáková; Ann Coloproctol. 2020;36(1):12-16. Published online March 3, 2020; DOI: https://doi.org/10.3393/ac.2018.10.15.2

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4 Citations

Abstract PDF

Purpose
The aim of this study was to determine whether a connection exists between Crohn disease and fungi, specifically Candida albicans, because one possible cause of disease is thought to be the presence of fungi in the intra-abdominal cavity. The diagnosis of invasive candidiasis is difficult due to the lack of specific clinical manifestations of the disease. A retrospective evaluation of the presence of invasive candidiasis was done in a group of 54 patients with Crohn disease and in a group of 31 patients who received surgery primarily for right-sided cancer of the colon.
Methods
Culture samples were obtained from the wall of the extraluminal portion of the terminal ileum and the adjacent mesenterium, and then sent to the microbiology laboratory for further investigation. Sabouraud agar (SGC2) and chromID Candida agar (CAN2) were used for both short-term (48 hours) and long-term (10 days) cultivation.
Results
Pearson chi-square test revealed a statistically significant difference in the prevalence of fungi and yeast between the 2 groups of patients (χ² = 4.3873, P < 0.05).
Conclusion
Patients with Crohn disease had a significantly higher prevalence of fungi and yeasts in the intra-abdominal cavity compared with cancer patients.

Citations

Citations to this article as recorded by

Longitudinal dynamics of gut bacteriome and mycobiome interactions pre- and post-visceral surgery in Crohn’s disease
Simon Wetzel, Alexander Müller, Eva Kohnert, Negin Mehrbarzin, Roman Huber, Georg Häcker, Clemens Kreutz, Ann-Kathrin Lederer, Mohamed Tarek Badr
Frontiers in Cellular and Infection Microbiology.2024;[Epub] CrossRef
Amyloid, Crohn’s disease, and Alzheimer’s disease - are they linked?
Anna Duda-Madej, Jakub Stecko, Natalia Szymańska, Agnieszka Miętkiewicz, Marta Szandruk-Bender
Frontiers in Cellular and Infection Microbiology.2024;[Epub] CrossRef
Opportunistic infections changed before and after SARS-CoV-2 infection in inflammatory bowel disease patients: a retrospective single-center study in China
Zhenzhen Fan, He Zhou, Jiaqi Zhang, Xiaoning Liu, Tong Wu, Yanting Shi, Junchao Lin, Jie Liang
Frontiers in Medicine.2024;[Epub] CrossRef
Fungal microbiome in inflammatory bowel disease: a critical assessment
David M. Underhill, Jonathan Braun
Journal of Clinical Investigation.2022;[Epub] CrossRef

Evaluation of a Seton Procedure Combined With Infliximab Therapy (Early vs. Late) in Perianal Fistula With Crohn Disease: Myunghoon Jeon, Kihwan Song, Jail Koo, Sohyun Kim; Ann Coloproctol. 2019;35(5):249-253. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2018.11.23.1

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11 Citations

Abstract PDF

Purpose
We assessed the clinical outcomes of a seton procedure combined with early versus late institution of infliximab (IFX) therapy.
Methods
This retrospective study comprised 76 patients who underwent surgery for perianal fistula associated with Crohn disease between January 2014 and November 2017. All patients underwent loose seton drainage combined with IFX therapy. Patients categorized as the early group (EG, 49 patients) received IFX therapy within 30 days of completion of the seton procedure. Patients categorized as the late group (LG, 27 patients) received IFX therapy >30 days after the seton procedure. IFX therapy was administered as induction and maintenance therapy.
Results
There were no statistically significant intergroup differences in clinical characteristics of the patients. The mean follow-up was 21.0 ± 11.6 months in the EG and 34.5 ± 18.4 months in the LG (P = 0.001). The mean interval between seton procedure and IFX induction therapy was 12.2 days in the EG and 250.2 days in the LG (P = 0.002). Complete remission was observed in 32 patients (65.3%) in the EG and 17 patients (63.0%) in the LG (P = 0.844). Fistula recurrence was observed in 6 patients (7.9%). All recurrences occurred in a previous perianal fistula tract.
Conclusion
Patients showed a good response to a seton procedure combined with IFX therapy regardless of the time of initiation of IFX therapy.

Citations

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Management of Perianal Fistulizing Crohn’s Disease
Arshdeep Singh, Vandana Midha, Gursimran Singh Kochhar, Bo Shen, Ajit Sood
Inflammatory Bowel Diseases.2024; 30(9): 1579. CrossRef
The use of core descriptors from the ENiGMA code study in recent literature: a systematic review
Saher‐Zahra Khan, Andrea Arline, Kate M. Williams, Matthew J. Lee, Emily Steinhagen, Sharon L. Stein
Colorectal Disease.2024; 26(3): 428. CrossRef
Impact of Seton Use on Clinical, Patient-Reported, and Healthcare Resource Utilization Outcomes in Complex Crohn’s Perianal Fistulas: A Systematic Literature Review
Ian White, Chitra Karki, Parnia Geransar, Lilia Leisle, Sophia Junker, Phillip Fleshner
Inflammatory Bowel Diseases.2024;[Epub] CrossRef
The Optimal Management of Fistulizing Crohn’s Disease: Evidence beyond Randomized Clinical Trials
Panu Wetwittayakhlang, Alex Al Khoury, Gustavo Drügg Hahn, Peter Laszlo Lakatos
Journal of Clinical Medicine.2022; 11(11): 3045. CrossRef
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula
Wolfgang B. Gaertner, Pamela L. Burgess, Jennifer S. Davids, Amy L. Lightner, Benjamin D. Shogan, Mark Y. Sun, Scott R. Steele, Ian M. Paquette, Daniel L. Feingold
Diseases of the Colon & Rectum.2022; 65(8): 964. CrossRef
Management of perianal fistula in inflammatory bowel disease: identification of prognostic factors associated with surgery
Sara Gortázar de Las Casas, Mario Alvarez-Gallego, Jose Antonio Gazo Martínez, Natalia González Alcolea, Cristina Barragán Serrano, Aitor Urbieta Jiménez, María Dolores Martín Arranz, Jose Luis Marijuan Martín, Isabel Pascual Migueláñez
Langenbeck's Archives of Surgery.2021; 406(4): 1181. CrossRef
Treatment Strategy for Perianal Fistulas in Crohn Disease Patients: The Surgeon’s Point of View
Jong Lyul Lee, Yong Sik Yoon, Chang Sik Yu
Annals of Coloproctology.2021; 37(1): 5. CrossRef
Multidisciplinary management of perianal Crohn's disease
Suha Abushamma, David H. Ballard, Radhika K. Smith, Parakkal Deepak
Current Opinion in Gastroenterology.2021; 37(4): 295. CrossRef
Approach to medical therapy in perianal Crohn’s disease
Abhinav Vasudevan, David H Bruining, Edward V Loftus, William Faubion, Eric C Ehman, Laura Raffals
World Journal of Gastroenterology.2021; 27(25): 3693. CrossRef
Infliximab

Reactions Weekly.2020; 1785(1): 284. CrossRef
Mesenchymal stem cells in perianal Crohn’s disease
H. Guadalajara, M. García-Arranz, M. Dolores Herreros, K. Borycka-Kiciak, A. L. Lightner, D. García-Olmo
Techniques in Coloproctology.2020; 24(8): 883. CrossRef

Current Status and Trends in Inflammatory Bowel Disease Surgery in Korea: Analysis of Data in a Nationwide Registry: Se-Jin Baek, Kil Yeon Lee, Ki Hwan Song, Chang Sik Yu, for the Inflammatory Bowel Disease (IBD) Study Group of the Korean Society of Coloproctology; Ann Coloproctol. 2018;34(6):299-305. Published online December 31, 2018; DOI: https://doi.org/10.3393/ac.2018.07.21

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Abstract PDF

Purpose
Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea.
Methods
Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016. Results: The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%.
Conclusion
The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.

Citations

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Clinical Significance of Prognostic Nutrition Index in Patients with Crohn’s Disease after Primary Bowel Resection
Hyeon Woo Bae, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Jae Hee Cheon, Joseph C. Carmichael, Byung Soh Min
Yonsei Medical Journal.2024; 65(7): 380. CrossRef
The Hydrophobic Amino Acid-Rich Fish Collagen Peptide Ameliorates Dextran Sulfate Sodium-Induced Ulcerative Colitis in Mice via Repairing the Intestinal Barrier, Regulating Intestinal Flora and AA Metabolism
Limei Yang, Yiting Wang, Xuan Li, Yonger Chen, Jian Liang, Lian He, Dongxu Jiang, Song Huang, Shaozhen Hou
Journal of Agricultural and Food Chemistry.2024; 72(46): 25690. CrossRef
Increased Proportion of Colorectal Cancer in Patients With Ulcerative Colitis Undergoing Surgery in the Netherlands
Lianne Heuthorst, Houda Harbech, Harmanna J. Snijder, Aart Mookhoek, Geert R. D'Haens, Séverine Vermeire, André D'Hoore, Willem A. Bemelman, Christianne J. Buskens
American Journal of Gastroenterology.2023; 118(5): 848. CrossRef
Optimal surgical management of duodenal fistula in Crohn’s disease: a Korean multicenter cohort study
Soo Young Oh, Young Il Kim, Yong Sik Yoon, Min Soo Cho, Min Young Park, Seung-Bum Ryoo, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Molecular characterization of dysplasia-initiated colorectal cancer with assessing matched tumor and dysplasia samples
Sungwon Jung, Jong Lyul Lee, Tae Won Kim, Jongmin Lee, Yong Sik Yoon, Kil Yeon Lee, Ki-hwan Song, Chang Sik Yu, Yong Beom Cho
Annals of Coloproctology.2022; 38(1): 72. CrossRef
New insights on the surgical management of ulcerative colitis in the 21st century
Paulo G Kotze, Lianne Heuthorst, Amy L Lightner, Aderson O M C Damião, Willem A Bemelman
The Lancet Gastroenterology & Hepatology.2022; 7(7): 679. CrossRef
Surgical management of Crohn’s disease: a state of the art review
Elise Maria Meima - van Praag, Christianne Johanna Buskens, Roel Hompes, Wilhelmus Adrianus Bemelman
International Journal of Colorectal Disease.2021; 36(6): 1133. CrossRef
Surgical options for perianal fistula in patients with Crohn's disease: A comparison of seton placement, fistulotomy, and stem cell therapy
Min Young Park, Yong Sik Yoon, Hyoung Eun Kim, Jong Lyul Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Asian Journal of Surgery.2021; 44(11): 1383. CrossRef
Improving the care of inflammatory bowel disease (IBD) patients: perspectives and strategies for IBD center management
Jihye Park, Sinyoung Park, Shin Ae Lee, Soo Jung Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2021; 36(5): 1040. CrossRef
Short-term and long-term outcomes of laparoscopic vs open ileocolic resection in patients with Crohn's disease: Propensity-score matching analysis
Shin Jeong Pak, Young Il Kim, Yong Sik Yoon, Jong Lyul Lee, Jung Bok Lee, Chang Sik Yu
World Journal of Gastroenterology.2021; 27(41): 7159. CrossRef
Effect of Age on the Initiation of Biologic Agent Therapy in Patients With Inflammatory Bowel Disease: Korean Common Data Model Cohort Study
Youn I Choi, Yoon Jae Kim, Jun-Won Chung, Kyoung Oh Kim, Hakki Kim, Rae Woong Park, Dong Kyun Park
JMIR Medical Informatics.2020; 8(4): e15124. CrossRef
Surgical Treatment of Upper Gastrointestinal Tract Crohn Disease: A Long Way to Go to Identify the Optimal Method
Soo Yeun Park
Annals of Coloproctology.2020; 36(4): 207. CrossRef
Clinical Characteristics and Postoperative Outcomes of Patients Presenting With Upper Gastrointestinal Tract Crohn Disease
Joon Suk Moon, Jong Lyul Lee, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Hassan Abdullah Alsaleem, Jin Cheon Kim
Annals of Coloproctology.2020; 36(4): 243. CrossRef
Effect of Thiopurine on Potential Surgical Intervention in Crohn’s Disease in Korea: Results from the CONNECT Study
Hee Man Kim, Jin Woo Kim, Hyun-Soo Kim, Joo Sung Kim, You Sun Kim, Jae Hee Cheon, Won Ho Kim, Byong Duk Ye, Won Moon, Sung Hee Jung, Young-Ho Kim, Dong Soo Han
Journal of Clinical Medicine.2020; 10(1): 25. CrossRef
What Are the Major Changes in Korean Inflammatory Bowel Disease Surgery?
Chang-Nam Kim
Annals of Coloproctology.2018; 34(6): 277. CrossRef

Does Anastomosis Configuration Influence Long-term Outcomes in Patients With Crohn Disease?: Parajuli Anuj, Yong Sik Yoon, Chang Sik Yu, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Jin Cheon Kim; Ann Coloproctol. 2017;33(5):173-177. Published online October 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.5.173

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Abstract PDF

Purpose

In this study, we evaluated the role of various anastomoses in surgical recurrence for patients with Crohn disease (CD).

Methods

We analyzed data retrospectively from consecutive laparotomy cases involving complicated CD between 1991 and 2008. Clinical data were compared in terms of reoperation-free survival (RFS) according to the types of anastomoses, the materials used for the anastomoses, and the operating surgeon.

Results

Of 233 patients with entero-enteric or entero-colic anastomoses, 199 (85%), 11 (5%), and 23 (10%) experienced side-to-side (SS), side-to-end (SE), and end-to-end (EE) anastomoses, respectively. The SS group had the following characteristics: more extensive bowel involvement, frequent obstruction, and greater stapler use; the SS anastomoses were also frequently made by specialized surgeons (P < 0.001–0.004). EE anastomoses were frequently made by general surgeons using a hand-sewing technique (P < 0.001). No differences in RFS were noted among the 3 groups according to the type of anastomosis and the operating surgeon. However, the hand-sewn group showed better RFS than the stapler group (P = 0.04).

Conclusion

The roles of the anastomotic configuration, the material used, and the operating surgeon were not significantly correlated with reoperations or complications in our retrospective CD cohort, irrespective of the higher risk of anastomosis site stricture for EE anastomoses.

Citations

Citations to this article as recorded by

Anastomosis after Bowel Resection for Crohn's Disease: State of the Art Review
Carla Newton, Alessandro Fichera
Clinics in Colon and Rectal Surgery.2024;[Epub] CrossRef
New anti-mesenteric delta-shaped stapled anastomosis: Technical report with short-term postoperative outcomes in patients with Crohn’s disease
Jong Lyul Lee, Yong Sik Yoon, Hyun Gu Lee, Young Il Kim, Min Hyun Kim, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
World Journal of Gastrointestinal Surgery.2024; 16(8): 2592. CrossRef
Results of the Eighth Scientific Workshop of ECCO: Pathophysiology and Risk Factors of Postoperative Crohn’s Disease Recurrence after an Ileocolonic Resection
Pauline Rivière, Gabriele Bislenghi, Nassim Hammoudi, Bram Verstockt, Steven Brown, Melissa Oliveira-Cunha, Willem Bemelman, Gianluca Pellino, Paulo Gustavo Kotze, Gabriele Dragoni, Mariangela Allocca, Nurulamin M Noor, Lieven Pouillon, Míriam Mañosa, Edo
Journal of Crohn's and Colitis.2023; 17(10): 1557. CrossRef
Ileocolic Resection for Crohn Disease: The Influence of Different Surgical Techniques on Perioperative Outcomes, Recurrence Rates, and Endoscopic Surveillance
Benjamin Click, Amit Merchea, Dorin T Colibaseanu, Miguel Regueiro, Francis A Farraye, Luca Stocchi
Inflammatory Bowel Diseases.2022; 28(2): 289. CrossRef
Anastomotic Techniques for Abdominal Crohn's Disease: Tricks and Tips
Marco Bertucci Zoccali, Alessandro Fichera
Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(8): 861. CrossRef
Short-term and long-term outcomes of laparoscopic vs open ileocolic resection in patients with Crohn's disease: Propensity-score matching analysis
Shin Jeong Pak, Young Il Kim, Yong Sik Yoon, Jong Lyul Lee, Jung Bok Lee, Chang Sik Yu
World Journal of Gastroenterology.2021; 27(41): 7159. CrossRef
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surgical Management of Crohn’s Disease
Amy L. Lightner, Jon D. Vogel, Joseph C. Carmichael, Deborah S. Keller, Samir A. Shah, Uma Mahadevan, Sunanda V. Kane, Ian M. Paquette, Scott R. Steele, • Daniel L. Feingold
Diseases of the Colon & Rectum.2020; 63(8): 1028. CrossRef
Correlation Between Anastomotic Configuration and Long-term Outcomes in Surgery for Crohn Disease
Jin-Su Kim, Ji-Yeon Kim
Annals of Coloproctology.2017; 33(5): 159. CrossRef

Case Report

Pulmonary Sarcoidosis That Developed During the Treatment of a Patient With Crohn Disease by Using Infliximab: Tae Kyun Kim, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Hyun Yong Jeong, Hyuk Soo Eun; Ann Coloproctol. 2017;33(2):74-77. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.74

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Abstract PDF

For inflammatory bowel disease (IBD), antitumor necrosis factor treatment offers a new direction for both patients and medical doctors. This treatment has dramatically improved the quality of life for patients with ulcerative colitis and Crohn disease (CD). However, with increasing usage and longer follow-up periods, a wider range of possible adverse effects may be encountered. We report an unusual case of pulmonary sarcoidosis developed during the treatment of a patient with CD by using infliximab. A 30-year-old male who had been treated for CD with infliximab for 18 months was admitted due to abnormal opacities on chest radiography. Chest computed tomography displayed clustered small nodules in both lobes and enlarged multiple lymph nodes. The patient was diagnosed with sarcoidosis from the results of a biopsy of the subcarinal lymph node. Lung lesions were improved five months after infliximab was stopped.

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Persistent Constitutional Symptoms and Cholestasis During Anti-TNF Therapy as a Harbinger of a Surprising Condition
Julio Maria Fonseca Chebli, Rogerio Khalil Akkari Evangelista, Liliana Andrade Chebli
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Sarcoidosis: federal clinical guidelines for diagnosis and treatment
A. G. Chuchalin, S. N. Avdeev, Z. R. Aisanov, O. P. Baranova, S. E. Borisov, N. A. Geppe, A. A. Vizel’, I. Yu. Vizel’, A. A. Zaicev, N. Y. Kravchenko, M. M. Ilkovich, O. V. Lovacheva, A. B. Malakhov, A. G. Malyavin, D. V. Petrov, V. V. Romanov, I. V. Sivo
PULMONOLOGIYA.2022; 32(6): 806. CrossRef
Development of pulmonary sarcoidosis in Crohn’s disease patient under infliximab biosimilar treatment after long-term original infliximab treatment: a case report and literature review
Shin Kashima, Kentaro Moriichi, Katsuyoshi Ando, Nobuhiro Ueno, Hiroki Tanabe, Sayaka Yuzawa, Mikihiro Fujiya
BMC Gastroenterology.2021;[Epub] CrossRef
An update on the diagnosis and management of ocular sarcoidosis
De-Kuang Hwang, Shwu-Jiuan Sheu
Current Opinion in Ophthalmology.2020; 31(6): 521. CrossRef
Assessment of the effect of alpha-tocopherol on the course of newly diagnosed pulmonary sarcoidosis: a comparative study
A. A. Vizel, D. A. Culver, I. Yu. Vizel, G. R. Shakirova, E. A. Bakunina
Tuberculosis and Lung Diseases.2020; 98(10): 33. CrossRef
Radiological Patterns of Lung Involvement in Inflammatory Bowel Disease
Diletta Cozzi, Chiara Moroni, Gloria Addeo, Ginevra Danti, Monica Marina Lanzetta, Edoardo Cavigli, Massimo Falchini, Fabio Marra, Claudia Lucia Piccolo, Luca Brunese, Vittorio Miele
Gastroenterology Research and Practice.2018; 2018: 1. CrossRef
Infliximab

Reactions Weekly.2017; 1657(1): 238. CrossRef

Original Articles

The Clinical Features and Predictive Risk Factors for Reoperation in Patients With Perianal Crohn Diseases; A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group: Jae Bum Lee, Seo-Gue Yoon, Kyu Joo Park, Kang Young Lee, Dae Dong Kim, Sang Nam Yoon, Chang Sik Yu; Ann Coloproctol. 2015;31(5):176-181. Published online October 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.5.176

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Abstract PDF

Purpose

Perianal lesions are common in Crohn disease, but their clinical course is unpredictable. Nevertheless, predicting the clinical course after surgery for perianal Crohn disease (PCD) is important because repeated operations may decrease patient's quality of life. The aim of this study was to predict the risk of reoperation in patients with PCD.

Methods

From September 1994 to February 2010, 377 patients with PCD were recruited in twelve major tertiary university-affiliated hospitals and two specialized colorectal hospitals in Korea. Data on the patient's demographics, clinical features, and surgical outcomes were analyzed.

Results

Among 377 patients, 227 patients were ultimately included in the study. Among the 227 patients, 64 patients underwent at least one reoperation. The median period of reoperation following the first perianal surgery was 94 months. Overall 3-year, 5-year, and 10-year cumulative rates of reoperation-free individuals were 68.8%, 61.2%, and 50.5%, respectively. In multivariate analysis (Cox-regression hazard model), reoperation was significantly correlated with an age of onset less than 20 years (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.07-3.48; P = 0.03), history of abdominal surgery (HR, 1.99; 95% CI, 1.08-3.64; P = 0.03), and the type of surgery. Among types of surgery, fistulotomy or fistulectomy was associated with a decreased incidence of reoperation in comparison with incision and drainage (HR, 0.19; 95% CI, 0.09-0.42; P < 0.001).

Conclusion

Young age of onset and a history of abdominal surgery were associated with a high risk of reoperation for PCD, and the risk of reoperation were relatively low in fistulotomy or fistulectomy procedures.

Citations

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A nanofiber-hydrogel composite improves tissue repair in a rat model of Crohn’s disease perianal fistulas
Ling Li, Zhi-Cheng Yao, Alyssa Parian, Yueh-Hsun Yang, Jeffrey Chao, Jason Yin, Kevan J. Salimian, Sashank K. Reddy, Atif Zaheer, Susan L. Gearhart, Hai-Quan Mao, Florin M. Selaru
Science Advances.2023;[Epub] CrossRef
Predictors of reoperation for perianal fistula in Crohn's disease
Kwangwoo Nam, Won Beom Jung, Seung Bum Lee, Jae Seung Soh, Song Soo Yang, Seok Won Jung
Journal of Digestive Diseases.2021; 22(6): 334. CrossRef
Perianal and Luminal Relapse Following Perianal Surgical Intervention in Crohn’s Disease
Feihong Deng, Pianpian Xia, Zengrong Wu, Hejun Zhou, Xuehong Wang
International Journal of General Medicine.2021; Volume 14: 3387. CrossRef
Predictors of Perianal Fistula Relapse in Crohn’s Disease
Audrey Malian, Pauline Rivière, Dominique Bouchard, François Pigot, Marianne Eléouet-Kaplan, Charlotte Favreau-Weltzer, Florian Poullenot, David Laharie
Inflammatory Bowel Diseases.2020; 26(6): 926. CrossRef
Predictors of Perianal Fistula Relapse in Crohn’s Disease
Dana J Lukin
Inflammatory Bowel Diseases.2019;[Epub] CrossRef
Management of Perianal Fistulas in Crohn’s Disease
Steffen Seyfried, Alexander Herold
Visceral Medicine.2019; 35(6): 338. CrossRef
Surgical management of fistulating perianal Crohn's disease: a UK survey
M. J. Lee, N. Heywood, P. M. Sagar, S. R. Brown, N. S. Fearnhead
Colorectal Disease.2017; 19(3): 266. CrossRef
Risk of Repeat Surgery for Perianal Crohn Disease
Doo Han Lee
Annals of Coloproctology.2015; 31(5): 169. CrossRef

Long-term Outcomes and Risk Factors for Reoperation After Surgical Treatment for Gastrointestinal Crohn Disease According to Anti-tumor Necrosis Factor-α Antibody Use: 35 Years of Experience at a Single Institute in Korea: Sang Mok Lee, Eon Chul Han, Seung-Bum Ryoo, Heung-Kwon Oh, Eun Kyung Choe, Sang Hui Moon, Joo Sung Kim, Hyun Chae Jung, Kyu Joo Park; Ann Coloproctol. 2015;31(4):144-152. Published online August 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.4.144

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Abstract PDF

Purpose

Crohn disease is characterized by high rates of recurrence and reoperations. However, few studies have investigated long-term surgical outcomes in Asian populations. We investigated risk factors for reoperation, particularly those associated with anti-tumor necrosis factor-α (anti-TNF-α) antibody use, and long-term follow-up results.

Methods

We reviewed the records of 148 patients (100 males and 48 females) who underwent surgery for gastrointestinal Crohn disease and retrospectively analyzed long-term outcomes and risk factors.

Results

The mean age at diagnosis was 28.8 years. Thirty-eight patients (25.7%) received monoclonal antibody treatment before reoperation. A small bowel and colon resection was most commonly performed (83 patients, 56.1%). The median follow-up was 149 months, during which 47 patients underwent reoperation. The median interval between the primary and the secondary surgeries was 65 months, with accumulated reoperation rates of 16.5%, 31.8%, and 57.2% after 5, 10, and 15 years, respectively. Obstruction was the most common indication for reoperation (37 patients, 25.0%). In a multivariable analysis, age <17 years at diagnosis (A1) (odds ratio [OR], 2.20; P = 0.023), penetrating behavior (B3) (OR, 4.39; P < 0.001), and no azathioprine use (OR, 2.87; P = 0.003) were associated with reoperation. Anti-TNF-α antibody use did not affect the reoperation rate (P = 0.767).

Conclusion

We showed a high reoperation rate regardless of treatment with anti-TNF-α antibody, which indicates that recurrent surgery is still needed to cure patients with gastrointestinal Crohn diseases. Younger age at primary operation, penetrating behavior, and no azathioprine use were significant factors associated with reoperation for gastrointestinal Crohn disease.

Citations

Citations to this article as recorded by

Inflammatory Bowel Disease Reoperation Rate Has Decreased Over Time If Corrected by Prevalence
Mafalda Santiago, Fernando Magro, Luís Correia, Francisco Portela, Paula Ministro, Paula Lago, Eunice Trindade, Cláudia Camila Dias
Clinical and Translational Gastroenterology.2020; 11(9): e00227. CrossRef
Effect of Thiopurine on Potential Surgical Intervention in Crohn’s Disease in Korea: Results from the CONNECT Study
Hee Man Kim, Jin Woo Kim, Hyun-Soo Kim, Joo Sung Kim, You Sun Kim, Jae Hee Cheon, Won Ho Kim, Byong Duk Ye, Won Moon, Sung Hee Jung, Young-Ho Kim, Dong Soo Han
Journal of Clinical Medicine.2020; 10(1): 25. CrossRef
Risk factors for postoperative surgical site infections in patients with Crohn’s disease receiving definitive bowel resection
Song Liu, Ji Miao, Gefei Wang, Meng Wang, Xiuwen Wu, Kun Guo, Min Feng, Wenxian Guan, Jianan Ren
Scientific Reports.2017;[Epub] CrossRef
Advanced age impacts surgical characteristics and postoperative course in patients with Crohn's disease
Stanislaus Argeny, Anton Stift, Martina Mittlböck, Amy C. Lord, Svenja Maschke, Mathias Schneeweiß, Stefan Riss
International Journal of Surgery.2016; 33: 182. CrossRef
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Pingnan Shan, Zhiyong Lu, Lihong Ye, Yaqin Fang, Suhong Tan, Guohong Xuan, Jincheng Ru, Liming Mao
Medical Science Monitor.2016; 22: 3722. CrossRef
Endoscopy-based management decreases the risk of postoperative recurrences in Crohn’s disease
Anne-Laure Boucher, Bruno Pereira, Stéphanie Decousus, Marion Goutte, Felix Goutorbe, Anne Dubois, Johan Gagniere, Corinne Borderon, Juliette Joubert, Denis Pezet, Michel Dapoigny, Pierre J Déchelotte, Gilles Bommelaer, Anthony Buisson
World Journal of Gastroenterology.2016; 22(21): 5068. CrossRef
Anti-tumor Necrosis Factor Therapy for Crohn Disease: Friend or Foe to the Surgeon?
Hungdai Kim
Annals of Coloproctology.2015; 31(4): 121. CrossRef

Case Report

A New Technique Using Ultra-slim Endoscopy for High-Grade Crohn's Stricture: Ga Hee Kim, Kyung-Jo Kim, Gi Ae Kim, Jee Eun Yang, Hee Jung Park, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang; J Korean Soc Coloproctol. 2012;28(5):271-274. Published online October 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.5.271

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3 Citations

Abstract PDF

Crohn's disease (CD) is a chronic inflammatory bowel disease of unknown etiology. Most patients with CD will eventually develop a stricturing or penetrating complication. Colonoscopic findings may predict the clinical course in patients with CD. Moreover, since CD patients are at increased risk for developing dysplasia and colorectal cancer, surveillance colonoscopy is necessary for the detection of malignancies. We describe here a CD patient with a high-grade anorectal stricture who successfully underwent a total colon examination with an ultra-slim upper endoscope after an insertion failure with a standard colonoscope and gastroscope.

Citations

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ECCO Topical Review Optimising Reporting in Surgery, Endoscopy, and Histopathology
Michel Adamina, Roger Feakins, Marietta Iacucci, Antonino Spinelli, Rosanna Cannatelli, André D’Hoore, Ann Driessen, Konstantinos Katsanos, Aart Mookhoek, Pär Myrelid, Gianluca Pellino, Georgios Peros, Gian Eugenio Tontini, Monika Tripathi, Henit Yanai, M
Journal of Crohn's and Colitis.2021; 15(7): 1089. CrossRef
Super-slim endoscopy, in a patient with a Crohn’s ileocecal valve stricture, for assessment of mucosal healing
S. Pontone, C. Cicerone, F. M. Magliocca, P. Vernia
Techniques in Coloproctology.2016; 20(4): 259. CrossRef
Clinical impact of ultrathin colonoscopy for Crohn's disease patients with strictures
Kenichi Morimoto, Kenji Watanabe, Atsushi Noguchi, Takako Miyazaki, Yasuaki Nagami, Satoshi Sugimori, Noriko Kamata, Mitsue Sogawa, Tetsuya Tanigawa, Hirokazu Yamagami, Masatsugu Shiba, Kazunari Tominaga, Toshio Watanabe, Yasuhiro Fujiwara, Tetsuo Arakawa
Journal of Gastroenterology and Hepatology.2015; 30(S1): 66. CrossRef

Review

A Comprehensive Review of Inflammatory Bowel Disease Focusing on Surgical Management: Seung Hyuk Baik, Won Ho Kim; J Korean Soc Coloproctol. 2012;28(3):121-131. Published online June 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.3.121

3,674 View
45 Download
4 Citations

Abstract PDF

The two main diseases of inflammatory bowel disease are Crohn's disease and ulcerative colitis. The pathogenesis of inflammatory disease is that abnormal intestinal inflammations occur in genetically susceptible individuals according to various environmental factors. The consequent process results in inflammatory bowel disease. Medical treatment consists of the induction of remission in the acute phase of the disease and the maintenance of remission. Patients with Crohn's disease finally need surgical treatment in 70% of the cases. The main surgical options for Crohn's disease are divided into two surgical procedures. The first is strictureplasty, which can prevent short bowel syndrome. The second is resection of the involved intestinal segment. Simultaneous medico-surgical treatment can be a good treatment strategy. Ulcerative colitis is a diffuse nonspecific inflammatory disease that involves the colon and the rectum. Patients with ulcerative colitis need surgical treatment in 30% of the cases despite proper medical treatment. The reasons for surgical treatment are various, from life-threatening complications to growth retardation. The total proctocolectomy (TPC) with an ileal pouch anal anastomosis (IPAA) is the most common procedure for the surgical treatment of ulcerative colitis. Medical treatment for ulcerative colitis after a TPC with an IPAA is usually not necessary.

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Epithelioid Hemangioendothelioma of the Bowel in Crohn’s Disease: The First Reported Case
Smiljana Spasic, Iva Brcic, Rochelle Freire, Monica T. Garcia-Buitrago, Andrew E. Rosenberg
International Journal of Surgical Pathology.2019; 27(4): 423. CrossRef
Extraintestinal Manifestations in Vedolizumab and Anti-TNF-Treated Patients With Inflammatory Bowel Disease
Marla C Dubinsky, Raymond K Cross, William J Sandborn, Millie Long, Xue Song, Nianwen Shi, Yao Ding, Samantha Eichner, Brandee Pappalardo, Arijit Ganguli, Anthony Wang
Inflammatory Bowel Diseases.2018; 24(9): 1876. CrossRef
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Usman T. Siddiqui, Hira Shahzad, Asad Jamil Raja
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Risk Factors for Repeat Abdominal Surgery in Patients with Crohn's Disease
Young Jin Kim
Journal of the Korean Society of Coloproctology.2012; 28(4): 175. CrossRef

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