Risk Factors for Postoperative Recurrence in Korean Patients with Crohn’s Disease
- Author:
Sung Bae KIM
1
;
Jae Hee CHEON
;
Jae Jun PARK
;
Eun Soo KIM
;
Seong Woo JEON
;
Sung-Ae JUNG
;
Dong Il PARK
;
Chang Kyun LEE
;
Jong Pil IM
;
You Sun KIM
;
Hyun Soo KIM
;
Jun LEE
;
Chang Soo EUN
;
Jeong Mi LEE
;
Byung Ik JANG
;
Geom Seog SEO
Author Information
- Publication Type:ORiginal Article
- From:Gut and Liver 2020;14(3):331-337
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:A considerable number of patients with Crohn’s disease still need intestinal resection surgery. Postoperative recurrence is an important issue in Crohn’s disease management, including the selection of high-risk patients. Eastern Asian patients showed several differences from Caucasian patients. Therefore, we investigated the postoperative surgical recurrence outcome and identified risk factors in Korean patients.
Methods:Clinical data of 372 patients with Crohn’s disease who underwent first intestinal resection between January 2004 and August 2014 at 14 hospitals in Korea were retrospectively reviewed.
Results:Over the follow-up period, 50 patients (17.1%) showed surgical recurrence. The cumulative surgical recurrence rate was 6.5% at 1 year and 15.4% at 7 years. Age under 16 (p=0.011; hazard ratio [HR], 5.136; 95% confidence interval [CI], 1.576 to 16.731), colonic involvement (p=0.023; HR , 2.011; 95% CI, 1.102 to 3.670), and the presence of perianal disease at surgery (p=0.008; HR, 2.239; 95% CI, 1.236 to 4.059) were independent risk factors associated with surgical recurrence. Postoperative thiopurine treatment (p=0.002; HR, 0.393; 95% CI, 0.218 to 0.710) was a protective factor for surgical recurrence.
Conclusions:Among the disease characteristics at surgery, younger age, colonic location, and perianal lesions were independent risk factors for surgical recurrence. Postoperative thiopurine treatment significantly reduced the incidence of surgical recurrence.
