Intest Res.  2014 Apr;12(2):117-123. 10.5217/ir.2014.12.2.117.

Clinical and Endoscopic Recurrence after Surgical Resection in Patients with Crohn's Disease

• Lee YW
• Lee KM
• Chung WC
• Paik CN
• Sung HJ
• Oh YS

• KMID: 2284896
• DOI: http://doi.org/10.5217/ir.2014.12.2.117

Abstract

BACKGROUND/AIMS
The natural history of Crohn's disease (CD) is characterized by a remitting and relapsing course and a considerable number of patients ultimately require bowel resection. Moreover, postoperative recurrence is very common. Relatively few studies have investigated the postoperative recurrence of CD in Korea. The aim of the current study was to assess postoperative recurrence rates - both clinical and endoscopic - in CD as well as factors influencing postoperative recurrence.
METHODS
Electronic medical records of patients who underwent surgery due to CD were reviewed and analyzed. Patients with incomplete surgical resection, a follow-up period of less than a year, and a history of strictureplasty or perianal surgery were excluded.
RESULTS
Of 112 CD patients, 39 patients had history of bowel resection, and 34 patients met the inclusion criteria. Among them, 26 were male (76%) and the mean age of onset was 32.8 years. The mean follow-up period after operation was 65.4 months. Cumulative clinical recurrence rates were 8.8%, 12.5%, and 33.5% at 12, 24, and 48 months, respectively. Use of immunomodulators for prophylaxis was the only predictor of clinical recurrence in univariate analysis (P=0.042). Of 21 patients who had undergone follow-up colonoscopy after surgery, cumulative endoscopic recurrence rates were 33.3%, 42.9%, and 66.1% at 6, 12, and 24 months, respectively. No significant predicting factor for endoscopic recurrence was detected.
CONCLUSIONS
Postoperative recurrence rates in Korean patients with CD are high, and endoscopic recurrence rates are comparable to those reported from Western studies. Appropriate medical prophylaxis seems to be important for preventing postoperative recurrence in CD.

Keyword

Postoperative recurrence; Crohn's disease; Endoscopic recurrence

MeSH Terms

Age of Onset
Colonoscopy
Crohn Disease*
Electronic Health Records
Follow-Up Studies
Humans
Immunologic Factors
Korea
Male
Natural History
Recurrence*
Immunologic Factors

Figure

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  Fig. 1 Inclusion and exclusion of enrolled patients.

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  Fig. 2 Cumulative recurrence rates in patients who underwent bowel resection.

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