BACKGROUND/AIMS: The majority of Crohn's disease patients undergo surgery. However, the factors that predict post-operative recurrence remain controversial. The aim of the present study was to shed light on the potential predictors of such recurrence. METHODS: 86 patients who underwent operative procedures for Crohn's disease were retrospectively studied. Recurrence was defined as the need for a second operation. Life table and multivariate analysis were performed to find the predictors of recurrence. RESULTS: In 26/86 (30%) of the patients, post-operative recurrence was diagnosed within a mean of 42 months of the follow-up. Logistic regression analysis revealed that smoking (OR 3.69, 95% CI 2.06-11.52) and perforating disease (OR 4.09, 95% CI 1.31-12.65) were associated with a risk of recurrence. However, survival analysis showed that only perforating disease was associated with an early post-operative recurrence (log-rank test, p < 0.001). Neither resected surgical specimen characteristics, nor the duration and the location of the disease were found to predict the need for a second operation. CONCLUSION: The risk for Crohn's disease patients who undergo surgery is related to the presence of perforating disease and smoking, which predict the need for a second operation. The former is associated with an even earlier recurrence.
BACKGROUND/AIMS: The majority of Crohn's diseasepatients undergo surgery. However, the factors that predict post-operative recurrence remain controversial. The aim of the present study was to shed light on the potential predictors of such recurrence. METHODS: 86 patients who underwent operative procedures for Crohn's disease were retrospectively studied. Recurrence was defined as the need for a second operation. Life table and multivariate analysis were performed to find the predictors of recurrence. RESULTS: In 26/86 (30%) of the patients, post-operative recurrence was diagnosed within a mean of 42 months of the follow-up. Logistic regression analysis revealed that smoking (OR 3.69, 95% CI 2.06-11.52) and perforating disease (OR 4.09, 95% CI 1.31-12.65) were associated with a risk of recurrence. However, survival analysis showed that only perforating disease was associated with an early post-operative recurrence (log-rank test, p < 0.001). Neither resected surgical specimen characteristics, nor the duration and the location of the disease were found to predict the need for a second operation. CONCLUSION: The risk for Crohn's diseasepatients who undergo surgery is related to the presence of perforating disease and smoking, which predict the need for a second operation. The former is associated with an even earlier recurrence.
Authors: Myles R Joyce; Christine D Hannaway; Scott A Strong; Victor W Fazio; Ravi P Kiran Journal: Langenbecks Arch Surg Date: 2011-10-22 Impact factor: 3.445
Authors: Thilo Welsch; Ulf Hinz; Thorsten Löffler; Gregor Muth; Christian Herfarth; Jan Schmidt; Peter Kienle Journal: Int J Colorectal Dis Date: 2007-03-28 Impact factor: 2.571
Authors: George E Reese; Theodore Nanidis; Catherine Borysiewicz; Takayuki Yamamoto; Timothy Orchard; Paris P Tekkis Journal: Int J Colorectal Dis Date: 2008-09-02 Impact factor: 2.571