Jean-Pierre Duffas, Emmanuelle Leteurtre, Carmen Stefanescu, Laurent Peyrin-Biroulet, Mathurin Fumery, Marion Simon, Stéphane Nancey, Romain Altwegg, Aurelien Amiot, Laurent Beaugerie, Vered Abitbol, Xavier Hébuterne, Xavier Roblin, Aude Bressenot, Guillaume Savoye, Jérémie H. Lefevre, Gilles Bommelaer, Guillaume Bouguen, Yoram Bouhnik, Anthony Buisson, Guillaume Pineton de Chambrun, Francesco Brunetti, F. Guillon, Pole des maladies de l'appareil digestif, gastroentérologie et assistance nutritive, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Amiens-Picardie, Hôpital Claude Huriez [Lille], CHU Lille, CHU Clermont-Ferrand, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de gastro-entérologie [Henri Mondor AP-HP, Créteil], Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hépato-gastro-entérologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Département de gastroentérologie, Hôpital Cochin [AP-HP], Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Hôpital Pontchaillou, Institut Mutualiste de Montsouris (IMM), Chirurgie Générale et Digestive [Rangueil], CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Centre Hospitalier Universitaire de Nice (CHU de Nice), Service d'hépato-gastroentérologie, Hospices Civils de Lyon (HCL), Département de gastro-entérologie et Hépatologie, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille, CHU Henri Mondor, The authors thank Patricia Détré, Association Francois Aupetit. This work was presented in part and orally at the European Crohn’s and Colitis Organization (ECCO) meeting in Copenhagen in 2014, at the Digestive Disease Week (DDW) in Chicago in 2014, and at the UEG week in Vienna in 2014., CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire de Nice (CHU Nice), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, CHU Henri Mondor [Créteil], Jonchère, Laurent, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
This work was presented in part and orally at the European Crohn’s and Colitis Organization (ECCO) meeting in Copenhagen in 2014, at the Digestive Disease Week (DDW) in Chicago in 2014 and at the UEG week in Vienna in 2014.; International audience; Background: Aims Colonic strictures complicate inflammatory bowel disease (IBD) and often lead to surgical resection to prevent dysplasia or cancer. We assessed the frequency of dysplasia and cancer among IBD patients undergoing resection of a colorectal stricture. Methods We analyzed data from the Groupe d’études et thérapeutiques des affections inflammatoires du tube digestif study. This was a nationwide retrospective study of 12,013 patients with IBD in France who underwent surgery for strictures at 16 centers, from August 1992 through January 2014 (293 patients for a colonic stricture, 248 patients with Crohn’s disease, 51% male, median age at stricture diagnosis was 38 y). Participants had no preoperative evidence of dysplasia or cancer. We collected clinical, endoscopic, surgical, and pathology data and information on outcomes. Results When patients were diagnosed with strictures, they had IBD for a median time of 8 y (3−14 y). The strictures were a median length of 6 cm (4−10 cm) and caused symptoms in 70% of patients. Of patients with Crohn’s disease, 3 were found to have low-grade dysplasia (1%), 1 was found to have high-grade dysplasia (0.4%), and 2 were found to have cancer (0.8%). Of patients with ulcerative colitis, 1 had low-grade dysplasia (2%), 1 had high-grade dysplasia (2%), and 2 had cancer (5%). All patients with dysplasia or cancer received curative surgery, except 1 who died of colorectal cancer during the follow-up period. No active disease at time of surgery was the only factor associated with dysplasia or cancer at the stricture site (odds ratio, 4.86; 95% confidence interval, 1.11–21.27; P=.036). Conclusion In a retrospective study of patients with IBD undergoing surgery for colonic strictures, 3.5% were found to have dysplasia or cancer. These findings can be used to guide management of patients with IBD and colonic strictures.