Surgical recurrence in Crohn's disease : a comparison between different types of bowel resections

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Aaltonen , G , Carpelan-Holmström , M , Keränen , I & Lepistö , A 2018 , ' Surgical recurrence in Crohn's disease : a comparison between different types of bowel resections ' , International Journal of Colorectal Disease , vol. 33 , no. 4 , pp. 473-477 . https://doi.org/10.1007/s00384-018-2995-9

Title: Surgical recurrence in Crohn's disease : a comparison between different types of bowel resections
Author: Aaltonen, Gisele; Carpelan-Holmström, Monika; Keränen, Ilona; Lepistö, Anna
Contributor: University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Department of Surgery
University of Helsinki, Clinicum
Date: 2018-04
Language: eng
Number of pages: 5
Belongs to series: International Journal of Colorectal Disease
ISSN: 0179-1958
URI: http://hdl.handle.net/10138/301100
Abstract: To compare recurrence frequency and location between different types of bowel resections in Crohn's disease patients. This was a retrospective study of consecutive patients undergoing bowel resection for Crohn's disease between 2006 and 2016. Type of primary operation was recorded and grouped as ileocolic resection, small bowel resection, segmental colon resection with colocolic anastomosis or colorectal anastomosis, colectomy with ileorectal anastomosis, or end stoma operation. Binary logistic regression was used to compare surgical recurrence frequency between groups. We also investigated how Crohn's disease location at reoperations was related to the primary bowel resection type. Altogether, 218 patients with a median follow-up of 4.7 years were included in our study. Reoperation was performed in 42 (19.3%) patients. The risk of reoperation using the ileocolic resection group as reference was the following: small bowel resection (odds ratio (OR) 2.95, 95% confidence interval (CI) 1.01-8.66; P = 0.049), segmental colon resection with colocolic or colorectal anastomosis (OR 6.20, 95% CI 2.04-18.87; P = 0.001), colectomy with ileorectal anastomosis (OR 26.57, 95% CI 2.59-273.01; P = 0.006), and end stoma operation (OR 4.62, 95% CI 1.90-11.26; P = 0.001). In case of surgical recurrence, the reoperation type and location correlated with the primary bowel resection type. Reoperation frequency in Crohn's disease is lower after ileocolic resection than after other types of bowel resections. Surgical recurrence in Crohn's disease tends to maintain the disease location of the primary operation. One third of Crohn's patients undergoing an end stoma operation will still need new bowel resections due to recurrence.
Subject: Crohn's disease
Reoperation
Recurrence
Ileocolic resection
Bowel resection
POSTOPERATIVE RECURRENCE
SEGMENTAL RESECTION
NATURAL-HISTORY
RISK-FACTORS
COLECTOMY
COLITIS
SURGERY
PATTERN
3126 Surgery, anesthesiology, intensive care, radiology
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