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 20 February 2018

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News

Diagnosis of postoperative recurrence of Crohn's disease

The sensitivity of wireless capsule endoscopy detecting Crohn's recurrence in the neoterminal ileum is inferior to that of ileocolonoscopy, find doctors in Gut.

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In this study, doctors from France compared ileocolonoscopy and wireless capsule endoscopy (WCE) for the detection of postoperative recurrence in Crohn's disease.

The team enrolled 32 patients in the study, and WCE and ileocolonoscopy were performed within 6 months of surgery.

Recurrence in the neoterminal ileum was defined by a Rutgeerts score 1.

There were 2 independent observers interpret the WCE. When WCE results did not concur they were regarded as either true negative or true positive. The team calculated sensitivity and specificity according to both assumptions.

Overall, the team found that there was disease recurrence in 21 patients; this was detected by ileocolonoscopy in 19 patients.

The sensitivity and specificity of ileocolonoscopy was 90% and 100%, respectively.
Gut

The sensitivity and specificity of ileocolonoscopy was 90% and 100%, respectively.

However, the sensitivity of WCE was 62% and 76% and specificity 100% and 90%, depending on assumptions.

The team identified a correlation between the severity of the lesions measured by both methods.

Lesions located outside the scope of conventional endoscopy were detected by WCE in two thirds of patients with excellent interobserver agreement.

Dr Bourreille's team concluded, "The sensitivity of WCE in detecting recurrence in the neoterminal ileum was inferior to that of ileocolonoscopy".

"In contrast, WCE detected lesions outside the scope of ileocolonoscopy in more than two thirds of patients".

"Additional follow up studies are needed to assess the clinical relevance of such lesions".

"At the present time, it seems that WCE cannot systematically replace ileocolonoscopy in the regular management of patients after surgery".

Gut 2006; 55: 978-83
13 June 2006

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