Jiajie Zhou1, Yi Li2, Jianfeng Gong2, Weiming Zhu2. 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.
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.
Authors: Shin Jeong Pak; Young Il Kim; Yong Sik Yoon; Jong Lyul Lee; Jung Bok Lee; Chang Sik Yu Journal: World J Gastroenterol Date: 2021-11-07 Impact factor: 5.742
Authors: Gian Paolo Caviglia; Chiara Angela Mineo; Chiara Rosso; Angelo Armandi; Marco Astegiano; Gabriella Canavese; Andrea Resegotti; Giorgio Maria Saracco; Davide Giuseppe Ribaldone Journal: J Clin Med Date: 2022-08-27 Impact factor: 4.964