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- Title
Surgical recurrence after primary ileocolic resection for Crohn's disease.
- Authors
Riss, S.; Schuster, I.; Papay, P.; Herbst, F.; Mittlböck, M.; Chitsabesan, P.; Stift, A.
- Abstract
Background: The current study was conducted to assess long-term outcomes after primary ileocolic resection for Crohn's disease (CD) and to identify factors associated with surgical relapse in the era of immunosuppressive medications. Methods: Data were collected retrospectively on 116 consecutive patients, who underwent primary ileocolic resection for CD at a tertiary referral center between 1997 and 2006. Medical records were reviewed, and the use of immunomodulators was noted. The cumulative probability for a second operation due to recurrent CD was described by Kaplan-Meier curves. Results: Ten patients (8.6 %) developed surgical recurrence after a mean follow-up period of 8.1 (±2.6) years. The percentage of patients not requiring further surgery was 96.5% and 88.0 % at 5 and 10 years, respectively. An urgent indication for surgery was significantly associated with the necessity of repeated intestinal resection (hazard ratio 5.6, 95 % confidence interval 1.2-27.0, p = 0.0145). In addition, postoperative exposure to azathioprine/6-mercaptopurine for more than 3 months decreased the probability of surgical recurrence significantly (hazard ratio 2.5, 95 % confidence interval 0.6-9.9, p = 0.0349). Conclusions: In contrast to previous studies, we observed a significant low surgical recurrence rate after primary ileocolic resection. Additionally, maintenance treatment with azathioprine/6-mercaptopurine after surgery may reduce the necessity for repeat surgical intervention.
- Subjects
SURGICAL excision; CROHN'S disease; IMMUNOLOGICAL adjuvants; MEDICAL informatics; INFLAMMATORY bowel diseases
- Publication
Techniques in Coloproctology, 2014, Vol 18, Issue 4, p365
- ISSN
1123-6337
- Publication type
Article
- DOI
10.1007/s10151-013-1061-4