Optimal delivery of follow-up care after surgery for Crohn’s disease: current perspectives

Figures & data

Table 1 Risk factors for endoscopic and clinical recurrence after surgery for Crohn’s disease

Confirmed risk factors	Probable risk factors	Investigational risk factors
Smoking	Shorter disease	Genetic mutations
Perforating disease	duration	Histological disease factors
Previous surgery	Disease location	Imaging findings
Myenteric plexitis	Extent of disease	Microbial diversity
	Granulomas	Type of anastamosis

Table 2 Models for defining patients at high-risk for postoperative Crohn’s disease recurrence proposed by various authors

Model	Characteristics of high-risk patients
De Cruz et al (2015)^Citation30	One or more of: smoking, perforating disease, or previous resection
Vaughn et al (2014)^Citation102	Two or more of: smoking, perforating disease, previous resection, or myenteric plexitis
Regueiro et al (2009)^Citation31	Perforating disease or history of multiple surgeries
Buisson et al (2012)^Citation33	Two or more of: smoking, previous resection, perforating disease, perianal location, or extensive bowel resection

Figure 1 Early postoperative management following surgery for Crohn’s disease.

Notes: The exact definition of high-risk is not standardized; however, we typically define high-risk as having two or more risk factors included in the “high-risk” box shown in the figure. Initiation of medical therapy is largely determined on the patient’s prior history. Anti-TNFs are the most efficacious therapy for preventing endoscopic and clinical recurrence.
Abbreviation: TNFs, tumor necrosis factors.

De CruzPKammMAHamiltonALCrohn’s disease management after intestinal resection: a randomised trialLancet201538599761406141725542620

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