Characterization and clinical behavior of @entity30 initially presenting predominantly as XXXX .

@entity1 @entity1944 @entity66 @entity738 @entity254 @entity31 @entity29 @entity1960 @entity30
PURPOSE: We studied @entity1 with @entity30 affecting the colon to characterize disease behavior and to determine whether such @entity1 might be candidates for sphincter-sparing surgery. METHODS: Ninety-two consecutive @entity1 with @entity30 were studied prospectively. Mean follow-up after diagnosis was 82 (range, 6-291) months. Parameters that were evaluated included previous surgery for @entity30 , granulomatous vs. @entity66 , extent of colonic involvement, and presence or absence of @entity66 . The clinical course of the disease and postoperative outcome were evaluated. The outcome of @entity30 @entity1 who underwent ileal pouch-anal @entity254 for presumed @entity31 was also evaluated. RESULTS: There were 39 @entity1 with @entity30 and 53 @entity1 without @entity738 . There was no statistical difference in the age of diagnosis or presence of small-bowel (23 vs. 27 percent), ileocolic (34 vs. 30 percent), or perineal (36 vs. 22 percent) disease in these @entity1 . At initial presentation, 88 percent of @entity1 with pancolitis had @entity1960 alone without other sites of @entity1944 compared with only 37 percent of @entity1 with segmental @entity1960 (P < 0.001). Kaplan-Meier analysis showed that @entity1 with @entity738 and @entity1 with segmental @entity1960 at presentation have a significantly higher recurrence when compared with @entity1 without @entity738 and @entity1 with pancolitis (P < 0.03). Thirteen @entity1 without @entity738 and eight with @entity738 underwent ileal pouch-anal @entity254 . Seven @entity1 (3 with @entity738 , 4 without @entity738 ) had a recurrence of @entity30 in the ileal pouch; 2 required pouch removal and permanent diversion for fistulizing disease in the ileal pouch and 5 were successfully treated conservatively without surgery. CONCLUSION: The presence of @entity738 and segmental involvement of the colon in @entity1 with @entity30 may reflect a more virulent clinical course. Ileal pouch-anal @entity254 may be considered as an option in select @entity1 with @entity30 without @entity29 . Based on our data, @entity1 with nongranulomatous pancolitis may be better candidates for sphincter-sparing surgery.
