Risk factors for symptomatic recurrence after intestinal resection for Crohn's disease: a retrospective study in a Chinese population

Risk factors, prediction, prevention and management of postoperative recurrence of Crohn's disease

Due to the repeated recurrence of Crohn's disease (CD), many CD patients have to undergo operative treatment. However, postoperative CD recurrence is common. Therefore, it is important for postoperative CD patients to realize the risk factors and predictors of postoperative recurrence in order to prevent recurrence and prolong remission. The purpose of the present review is to discuss the risk factors, prediction, prevention and postoperative management of postoperative CD recurrence.

Surgical recurrence after primary ileocolic resection for Crohn's disease

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.