Zhen Guo1, Lei Cao1, Feilong Guo1, Jianfeng Gong1, Yi Li1, Lili Gu1, Weiming Zhu2, Jieshou Li1. 1. Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, People's Republic of China. 2. Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, People's Republic of China. juwiming@nju.edu.cn.
Abstract
BACKGROUND: The purpose of the study was to identify risk factors for early clinical and surgical recurrence in Crohn's disease (CD) patients who underwent intestinal resection. METHOD: This was a retrospective study. Consecutive patients who underwent intestinal resection with a primary anastomosis from January 2011-December 2014 were enrolled. Gender, age at surgery, clinical phenotypes of CD, serum albumin and C-reactive protein level the day before surgery, smoking status at surgery, anastomosis technique, number of anastomoses, details of postoperative complications, the postoperative prophylactic treatment were assessed to figure out risk factors for postoperative clinical and surgical recurrence within 1 year after the initial resection by univariate and then multivariate analysis. RESULTS: Two hundred and thirty-seven patients were analyzed. The risk of early postoperative clinical recurrence was 2.99 times higher in patients suffered postoperative infectious complications [odds ratio (OR) 2.99; 95% CIs, 1.42-6.32; p = 0.004], while never-smoking was found to be a protective factor for early clinical recurrence (OR 0.326; 95% CIs, 0.18-0.59; p < 0.0001). For surgical recurrence within 1 year after resection, the presence of postoperative intra-abdominal septic complications might be a risk factor (OR 6.77; 95% CIs, 1.61-28.5; p = 0.009). Smoker at surgery was also a risk factor for early surgical recurrence (OR 5.41; 95% CIs, 1.36-21.5; p = 0.017). CONCLUSION: The presence of postoperative infectious complications was identified as a possible risk factor for early postoperative clinical recurrence after resection in CD patients.
BACKGROUND: The purpose of the study was to identify risk factors for early clinical and surgical recurrence in Crohn's disease (CD) patients who underwent intestinal resection. METHOD: This was a retrospective study. Consecutive patients who underwent intestinal resection with a primary anastomosis from January 2011-December 2014 were enrolled. Gender, age at surgery, clinical phenotypes of CD, serum albumin and C-reactive protein level the day before surgery, smoking status at surgery, anastomosis technique, number of anastomoses, details of postoperative complications, the postoperative prophylactic treatment were assessed to figure out risk factors for postoperative clinical and surgical recurrence within 1 year after the initial resection by univariate and then multivariate analysis. RESULTS: Two hundred and thirty-seven patients were analyzed. The risk of early postoperative clinical recurrence was 2.99 times higher in patients suffered postoperative infectious complications [odds ratio (OR) 2.99; 95% CIs, 1.42-6.32; p = 0.004], while never-smoking was found to be a protective factor for early clinical recurrence (OR 0.326; 95% CIs, 0.18-0.59; p < 0.0001). For surgical recurrence within 1 year after resection, the presence of postoperative intra-abdominal septic complications might be a risk factor (OR 6.77; 95% CIs, 1.61-28.5; p = 0.009). Smoker at surgery was also a risk factor for early surgical recurrence (OR 5.41; 95% CIs, 1.36-21.5; p = 0.017). CONCLUSION: The presence of postoperative infectious complications was identified as a possible risk factor for early postoperative clinical recurrence after resection in CDpatients.
Authors: Geert D'Haens; Filip Baert; Gert van Assche; Philip Caenepeel; Philippe Vergauwe; Hans Tuynman; Martine De Vos; Sander van Deventer; Larry Stitt; Allan Donner; Severine Vermeire; Frank J Van De Mierop; Jean-Charles R Coche; Janneke van der Woude; Thomas Ochsenkühn; Ad A van Bodegraven; Philippe P Van Hootegem; Guy L Lambrecht; Fazia Mana; Paul Rutgeerts; Brian G Feagan; Daniel Hommes Journal: Lancet Date: 2008-02-23 Impact factor: 79.321
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: David B Sachar; Eric Lemmer; Christopher Ibrahim; Yair Edden; Thomas Ullman; Julie Ciardulo; Esther Roth; Adrian J Greenstein; Joel J Bauer Journal: Inflamm Bowel Dis Date: 2009-07 Impact factor: 5.325
Authors: Constantinos Simillis; Takayuki Yamamoto; George E Reese; Satoru Umegae; Koichi Matsumoto; Ara W Darzi; Paris P Tekkis Journal: Am J Gastroenterol Date: 2007-09-25 Impact factor: 10.864