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Kim SJ, Park EJ, Bae HW, Lee YJ, Park MY, Yang SY, Han YD, Cho MS, Hur H, Carmichael JC, Min BS, Lee KY. Risk Factors of Reoperation in Patients with Intestinal Behçet's Disease Treated by Initial Bowel Resection. J Clin Med 2024; 13:6771. [PMID: 39597915 PMCID: PMC11594750 DOI: 10.3390/jcm13226771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 11/06/2024] [Accepted: 11/07/2024] [Indexed: 11/29/2024] Open
Abstract
Background/Objectives: Intestinal Behçet's disease (iBD) often requires surgical intervention, with a significant proportion of patients needing reoperation. This study aimed to investigate the risk factors associated with reoperation in patients with iBD who underwent initial bowel resection and to evaluate the perioperative and long-term outcomes in these patients. Methods: This was a retrospective case-control study analyzing patients who underwent their initial bowel resection due to iBD between 2005-2021 at a tertiary referral hospital. Reoperation was considered a surgery due to postoperative complications (within 30 days of the initial surgery) or disease progression. Results: A total of 81 patients were included. The median follow-up duration was 107.1 months, during which 26 patients (32%) underwent reoperation. Multivariable analysis showed that the presence of hematological disorders (hazards ratio [HR], 9.13; 95% confidence interval [CI], 3.79-22.02, p < 0.001), higher c-reactive protein (CRP) levels before the initial surgery (HR, 1.01; 95% CI, 1.01-1.02, p < 0.001), and a shorter specimen resection length (HR, 0.96; 95% CI, 0.93-0.99, p = 0.011) were risk factors for reoperation. Patients who underwent reoperation had higher rates of postoperative complications (69.2% vs. 43.6%, p = 0.031), required longer antibiotic use (12 vs. 7 days, p = 0.012), and had extended hospital stays (18 vs. 9 days, p = 0.011). They also had worse 5-year survival rates than those who did not undergo reoperation (83.5% vs. 98.4%, p = 0.012). Conclusions: Concurrent hematological disorders, high preoperative CRP levels, and short specimen resection were associated with an increased risk of reoperation in patients with iBD who underwent their initial bowel resections. They also had worse perioperative and long-term outcomes.
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Affiliation(s)
- Sun Jung Kim
- Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea;
- Graduate School of Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Eun Ji Park
- Department of Surgery, Kyung Hee University School of Medicine, Seoul 02447, Republic of Korea;
| | - Hyeon Woo Bae
- Division of Colorectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (H.W.B.); (M.Y.P.); (S.Y.Y.); (Y.D.H.); (H.H.); (B.S.M.); (K.Y.L.)
| | - Yong Joon Lee
- Department of Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Republic of Korea;
| | - Min Young Park
- Division of Colorectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (H.W.B.); (M.Y.P.); (S.Y.Y.); (Y.D.H.); (H.H.); (B.S.M.); (K.Y.L.)
| | - Seung Yoon Yang
- Division of Colorectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (H.W.B.); (M.Y.P.); (S.Y.Y.); (Y.D.H.); (H.H.); (B.S.M.); (K.Y.L.)
| | - Yoon Dae Han
- Division of Colorectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (H.W.B.); (M.Y.P.); (S.Y.Y.); (Y.D.H.); (H.H.); (B.S.M.); (K.Y.L.)
| | - Min Soo Cho
- Division of Colorectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (H.W.B.); (M.Y.P.); (S.Y.Y.); (Y.D.H.); (H.H.); (B.S.M.); (K.Y.L.)
| | - Hyuk Hur
- Division of Colorectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (H.W.B.); (M.Y.P.); (S.Y.Y.); (Y.D.H.); (H.H.); (B.S.M.); (K.Y.L.)
| | - Joseph C. Carmichael
- Division of Colon and Rectal Surgery, Department of Surgery, School of Medicine, University of California, Irvine, CA 92697, USA;
| | - Byung Soh Min
- Division of Colorectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (H.W.B.); (M.Y.P.); (S.Y.Y.); (Y.D.H.); (H.H.); (B.S.M.); (K.Y.L.)
| | - Kang Young Lee
- Division of Colorectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (H.W.B.); (M.Y.P.); (S.Y.Y.); (Y.D.H.); (H.H.); (B.S.M.); (K.Y.L.)
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