Resection rate curves by location along the small intestine provide perspectives on characteristics of Crohn’s disease

  • Hideyuki Suzuki
    Department of Surgery Tohoku University Graduate School of Medicine Sendai Japan
  • Kazuhiro Watanabe
    Department of Surgery Tohoku University Graduate School of Medicine Sendai Japan
  • Atsushi Kohyama
    Department of Surgery Tohoku University Graduate School of Medicine Sendai Japan
  • Shinobu Ohnuma
    Department of Surgery Tohoku University Graduate School of Medicine Sendai Japan
  • Hideaki Karasawa
    Department of Surgery Tohoku University Graduate School of Medicine Sendai Japan
  • Taiki Kajiwara
    Department of Surgery Tohoku University Graduate School of Medicine Sendai Japan
  • Minoru Kobayashi
    Department of Surgery Tohoku University Graduate School of Medicine Sendai Japan
  • Yuuri Hatsuzawa
    Department of Surgery Tohoku University Graduate School of Medicine Sendai Japan
  • Takashi Kamei
    Department of Surgery Tohoku University Graduate School of Medicine Sendai Japan
  • Michiaki Unno
    Department of Surgery Tohoku University Graduate School of Medicine Sendai Japan

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<jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>Crohn's disease (CD) can affect any part of the gastrointestinal tract; however, the frequency of CD lesions differs by location. This work aimed to examine resection rates by location to clarify locational characteristics of the small intestine in surgical CD cases.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>This was a single‐centre retrospective case note review of patients who had undergone resection for CD affecting the small intestine between January 2014 and February 2020. Operative details, including length of the small intestine, location and extent of the resection, identified the pattern of disease. By normalizing these data the resection rate along the length of the intestine was calculated to create resection rate curves.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>One hundred and twenty six surgical cases were identified. The resection rate curves could be divided into two types: exponential and bimodal. For primary surgery, this depended on whether or not surgery was limited to an ileocolic resection. At subsequent surgery, a previous ileocaecal resection influenced the pattern of disease. The peaks of the bimodal curve were located at the proximal and distal ileum.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>CD patients requiring resection of the small intestine can be divided into terminal ileum type (exponential type) and proximal ileum type (bimodal type). In the future this analytical method may help predict the site of any recurrent disease but also provides a new perspective on the disease.</jats:p></jats:sec>

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