Retrospective Cohort Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 21, 2016; 22(47): 10380-10387
Published online Dec 21, 2016. doi: 10.3748/wjg.v22.i47.10380
Factors associated with surgery in patients with intra-abdominal fistulizing Crohn's disease
Shaul Yaari, Ariel Benson, Eyal Aviran, Naama Lev Cohain, Ran Oren, Jacob Sosna, Eran Israeli
Shaul Yaari, Ariel Benson, Eyal Aviran, Ran Oren, Eran Israeli, IBD Unit, Institute of Gastroenterology and Liver Diseases, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
Naama Lev Cohain, Jacob Sosna, Department of Radiology and Medical Imaging, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
Author contributions: Yaari S, Sosna J and Israeli E designed the research; Yaari S, Benson A, Aviran E, Lev Cohain N and Sosna J performed the research; Yaari S, Benson A, Lev Cohain N and Israeli E analyzed the data; Yaari S, Benson A, Oren R, Sosna J and Israeli E wrote the paper; Oren R and Israeli E critically revised the manuscript for important intellectual content.
Institutional review board statement: This study was reviewed and approved by the Hadassah- Hebrew University Helsinki committee.
Informed consent statement: Informed consent was waived by the Hadassah-Hebrew University Helsinki committee due to the fact that this was a retrospective observational study, and the identity of all subjects participating in the study remained anonymous.
Conflict-of-interest statement: None for all authors.
Data sharing statement: Clinical dataset available from the corresponding author at email: erani@hadassah.org.il. Participant consent was not obtained but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Eran Israeli, MD, MHA, Head, IBD Unit, Institute of Gastroenterology and Liver Diseases, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel. erani@hadassah.org.il
Telephone: +972-2-6776848 Fax: +972-2-6437492
Received: August 27, 2016
Peer-review started: August 28, 2016
First decision: September 21, 2016
Revised: October 3, 2016
Accepted: October 31, 2016
Article in press: October 31, 2016
Published online: December 21, 2016
Processing time: 114 Days and 4.7 Hours
Core Tip

Core tip: We performed a longitudinal cohort study to identify radiological and clinical parameters that are associated with surgery within one-year of diagnosis of fistulae by cross-sectional imaging. We retrospectively reviewed 126 Crohn’s disease (CD) patients with intra-abdominal fistulae. Radiologic features that were associated with subsequent surgery included: multiple fistulae, presence of stricture, and an entero-vesical fistula. Evidence of an abscess, lymphadenopathy, or intense bowel enhancement was not associated with an increased rate of surgery. In multivariate analysis only the presence of a stricture was independently associated with an increased rate of surgery. These findings should be taken in to account when making therapeutic decisions for patients with fistulizing CD.