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Turk J Gastroenterol. 2018 Nov;29(6):655-663. doi: 10.5152/tjg.2018.17774.

Frequency and risk factors of surgical recurrence of Crohn's disease after primary bowel resection.

Author information

1
Department of General Surgery, Nanjing Medical University Jingling Clinical Medical College, Nanjing, China; Department of General Surgery, Nanjing Medical University Huai'an First People's Hospital, Huai'an, China.
2
Department of General Surgery, Nanjing Medical University Jingling Clinical Medical College, Nanjing, China.

Abstract

BACKGROUND/AIMS:

The purpose of this study was to evaluate the frequency and risk factors associated with Crohn's disease (CD) reoperation after primary bowel resection.

MATERIALS AND METHODS:

We identified 166 patients suffering from CD with primary bowel resection and primary anastomosis from the clinical database of a university hospital. The cumulative recurrence rate and median recurrence-free survival (RFS) were calculated using the Kaplan-Meier analysis. Categorical variables were compared using a log-rank test. A Cox proportional hazard model was used for multivariate analysis.

RESULTS:

The median age of reoperation was 30 years, and the median RFS was 30 months. The reoperation intervention rate was 16.9%. It was shown that smoking (p=0.015) and jejunoileal anastomosis (p=0.002) were significantly closely correlated to an increased risk of surgical recurrence, whereas laparoscopy (p=0.039), side-to-side anastomosis (p=0.018), and anastomotic stoma wider than 3 cm (p=0.024) were significantly closely correlated to a reduced risk of surgical recurrence.

CONCLUSION:

This study provided a robust result that smoking and small intestinal lesions were the risk factors of surgical recurrence for patients with CD upon the initial gut resection. Laparoscopy, side-to-side anastomosis, and wide anastomotic stoma were found to be protective factors against surgical recurrence.

PMID:
30381273
PMCID:
PMC6284675
DOI:
10.5152/tjg.2018.17774
[Indexed for MEDLINE]
Free PMC Article

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