Endoscopy after surgery in inflammatory bowel disease: Crohn's disease recurrence and pouch surveillance

Edoardo Vespa, Federica Furfaro, Mariangela Allocca, Gionata Fiorino, Carmen Correale, Daniela Gilardi, Marjorie Argollo, Alessandra Zilli, Eirini Zacharopoulou, Laura Loy, Silvio Danese

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: Crohn's disease (CD) and ulcerative colitis (UC) are immune-mediated disorders characterized by a chronic inflammation, with intermittent exacerbations of symptoms and inflammation. In both diseases, medical treatment has made revolutionary steps forward. Nevertheless, surgery is still required in many cases due to inefficacy of multiple medical therapies. It is not clear whether surgery rates in inflammatory bowel diseases (IBD) are currently decreasing despite all improvements.

AREAS COVERED: Multidisciplinary management is critical in surgical patients to improve long-term outcomes. Endoscopy plays a crucial role, both before and after surgery, in planning therapeutic strategies and stratifying risk of recurrence. Aim of this review is to provide a deeper insight into the central role of endoscopy in the postoperative management of IBD patients, focusing on recent research advances, future challenges and unresolved questions.

EXPERT OPINION: Both UC and CD surgical patients need endoscopy to define the correct therapeutic choice, predict subsequent disease course and adopt the correct surveillance strategy. In the next future, newer endoscopic techniques could be systematically applied in IBD patients after surgery, to assess early postoperative inflammation, response to treatment, or, regarding UC, to provide enhanced pouch surveillance, allowing for early detection of inflammation and dysplasia.

Original languageEnglish
Pages (from-to)829-841
Number of pages13
JournalExpert Review of Gastroenterology and Hepatology
Volume14
Issue number9
DOIs
Publication statusPublished - Sep 2020

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