The association of cigarette smoking with a high risk of recurrence after ileocolonic resection for ileocecal Crohn's disease.

The purpose of this retrospective study was to examine the influence of cigarette smoking on the recurrence of Crohn's disease after resection. Between 1975 and 1990, 141 patients underwent primary ileocolonic resection for ileocecal Crohn's disease, 79 of whom were nonsmokers and 62 of whom were smokers at the time of their operation. The 5- and 10-year cumulative recurrence-free rates were 65% and 45% for the smokers, and 81% and 64% for the nonsmokers, the former values being significantly lower than the latter values (P = 0.007). The smokers were further divided into two subgroups according to the number of cigarettes smoked per day; as mild smokers who smoked fewer than 15 per day (n = 31) and heavy smokers who smoked 15 or more per day (n = 31). The cumulative recurrence-free rate was lower in the heavy smokers compared with the mild smokers. These findings strongly suggest that smoking is associated with a high recurrence rate after ileocolonic resection for ileocecal Crohn's disease.