BACKGROUND: Data on risk factors of postoperative recurrence in patients with Crohn's disease (CD) have shown conflicting results. The aim of this retrospective study is to identify predictors of early symptomatic recurrence of CD after surgical intestinal resection in the Chinese population. MATERIALS AND METHODS: Patients diagnosed as CD who underwent intestinal resection in Jinling Hospital between May 2004 and December 2010 were included in our study. Clinical data of these patients were reviewed. Multivariable survival analysis was performed to elucidate risk factors of early postoperative symptomatic recurrence. RESULTS: There were a total of 141 CD patients who had at least one previous curative resection for CD under regular follow-up in our unit. Our data indicated disease behavior (95 % CI 1.01-1.70, P = 0.044), smoking habits (95 % CI 1.32-2.84, P = 0.001), indication of perforation (95 % CI 1.09-4.02, P = 0.026), and location of anastomosis (95 % CI 1.09-3.39, P = 0.023) which are, as a result, strong independent predictors of symptomatic recurrence, while the anastomosis type as side-to-side anastomosis (SSA) was significantly associated with a decreased risk of symptomatic recurrence when compared with other anastomosis type (95 % CI 0.26-0.94, P = 0.038). Medical prophylaxes also played a role in the prevention of postoperative symptomatic recurrence. CONCLUSIONS: A smoking habits and perforation indication for surgery at the time of resection are associated with an increased risk of symptomatic recurrence. Anastomosis type with SSA is associated with a reduced risk of symptomatic recurrence. This population-based study supports the concept that environmental factors, disease character, and surgical technique influence the risk of postoperative symptomatic recurrence of CD.
BACKGROUND: Data on risk factors of postoperative recurrence in patients with Crohn's disease (CD) have shown conflicting results. The aim of this retrospective study is to identify predictors of early symptomatic recurrence of CD after surgical intestinal resection in the Chinese population. MATERIALS AND METHODS:Patients diagnosed as CD who underwent intestinal resection in Jinling Hospital between May 2004 and December 2010 were included in our study. Clinical data of these patients were reviewed. Multivariable survival analysis was performed to elucidate risk factors of early postoperative symptomatic recurrence. RESULTS: There were a total of 141 CDpatients who had at least one previous curative resection for CD under regular follow-up in our unit. Our data indicated disease behavior (95 % CI 1.01-1.70, P = 0.044), smoking habits (95 % CI 1.32-2.84, P = 0.001), indication of perforation (95 % CI 1.09-4.02, P = 0.026), and location of anastomosis (95 % CI 1.09-3.39, P = 0.023) which are, as a result, strong independent predictors of symptomatic recurrence, while the anastomosis type as side-to-side anastomosis (SSA) was significantly associated with a decreased risk of symptomatic recurrence when compared with other anastomosis type (95 % CI 0.26-0.94, P = 0.038). Medical prophylaxes also played a role in the prevention of postoperative symptomatic recurrence. CONCLUSIONS: A smoking habits and perforation indication for surgery at the time of resection are associated with an increased risk of symptomatic recurrence. Anastomosis type with SSA is associated with a reduced risk of symptomatic recurrence. This population-based study supports the concept that environmental factors, disease character, and surgical technique influence the risk of postoperative symptomatic recurrence of CD.
Authors: R Caprilli; M A Gassull; J C Escher; G Moser; P Munkholm; A Forbes; D W Hommes; H Lochs; E Angelucci; A Cocco; B Vucelic; H Hildebrand; S Kolacek; L Riis; M Lukas; R de Franchis; M Hamilton; G Jantschek; P Michetti; C O'Morain; M M Anwar; J L Freitas; I A Mouzas; F Baert; R Mitchell; C J Hawkey Journal: Gut Date: 2006-03 Impact factor: 23.059
Authors: M Cottone; M Rosselli; A Orlando; L Oliva; A Puleo; M Cappello; M Traina; F Tonelli; L Pagliaro Journal: Gastroenterology Date: 1994-03 Impact factor: 22.682
Authors: Marian C Aldhous; Hazel E Drummond; Niall Anderson; Linda A Smith; Ian D R Arnott; Jack Satsangi Journal: Am J Gastroenterol Date: 2007-03 Impact factor: 10.864
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
Authors: Pei-Qi Wang; Jun Hu; Elie S Al Kazzi; Eboselume Akhuemonkhan; Min Zhi; Xiang Gao; Raquel Holand de Paula Pessoa; Sami Ghazaleh; Tuhina Cornelius; Suhel Abbas Sabunwala; Shadi Ghadermarzi; Kartikeya Tripathi; Mark Lazarev; Pin-Jin Hu; Susan Hutfless Journal: World J Gastrointest Pharmacol Ther Date: 2016-11-06