Das postoperative Rezidiv des M. Crohn - Ursachen und Risiken

Mirow, Lutz; Hauenschild, Lena; Hildebrand, P.; Kleemann, Markus; Keller, Ronald; Franke, C.; Roblick, UJ; Bruch, Hans–Peter; Kujath, P.

doi:10.1055/s-2008-1004743

Cited by 12 publications

(8 citation statements)

References 26 publications

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“…This result is significantly different from other reports. In other studies, penetrating behavior was a risk factor for postsurgical recurrence [8, 18-20]. However, Khoury et al [21] reported that stricturing behavior was a risk factor for early reoperation.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Repeat Abdominal Surgery in Korean Patients with Crohn's Disease: A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group

Lee

et al. 2012

J Korean Soc Coloproctol

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PurposeThe purpose of this study was to assess the risk factors for repeated abdominal surgery in Crohn's disease (CD) patients after the first abdominal surgery. Prior studies have tried to identify the risk factors for postoperative recurrence in CD patients, but the results of the studies have been inconsistent. Furthermore, few data on the risk factors for repeated abdominal surgery are available.MethodsClinical data on CD patients who underwent abdominal surgery from January 2000 to December 2009 were collected from seventeen university hospitals and one colorectal clinic. Data from a total of 708 patients were analyzed to find the risk factors for repeated abdominal surgery in CD patients. The mean follow-up period was 72 months.ResultsThe risk of repeated abdominal surgery was 3 times higher in young patients (below 16 years old) than in older patients (odds ratio [OR], 3.056; 95% confidence interval [CI], 1.021 to 9.150); P = 0.046). Stricturing behavior at diagnosis was also a risk factor for repeated abdominal surgery (OR, 2.438; 95% CI, 1.144 to 5.196; P = 0.021). Among operative indications, only intra-abdominal abscess was associated with repeated abdominal surgery (OR, 2.393; 95% CI, 1.098 to 5.216; P = 0.028). Concerning type of operation, an ileostomy might be a risk factor for repeated abdominal surgery (OR, 11.437; 95% CI, 1.451 to 90.124; P = 0.021). Emergency surgery (OR, 4.994; 95% CI, 2.123 to 11.745; P < 0.001) and delayed diagnosis after surgery (OR, 2.339; 95% CI, 1.147 to 4.771; P = 0.019) also increased the risk of repeated abdominal surgery.ConclusionYoung age (below 16 years), stricturing behavior, intra-abdominal abscess, emergency surgery, and delayed diagnosis after surgery were identified as possible risk factors for repeated abdominal surgery in CD patients.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Repeat Abdominal Surgery in Korean Patients with Crohn's Disease: A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group

Lee

et al. 2012

J Korean Soc Coloproctol

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“…Results depend of definition of recurrence. Using, the need for a second resection as the definition for recurrent disease, authors found a recurrence rate of about 20% at 5 years and 35% at 10 years [4,[5][6][7][8][9][10][11][12][13]. In the present study the risk of recurrence was lesser than the previous reports, it was about 7.5%.…”

Section: Discussionmentioning

confidence: 40%

Risk Factors of Surgical Recurrence after Resection for Crohn’s Disease

Makni¹

2017

Austin J Gastroenterol

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Objective: The surgery is required in more than 80% of patients with Crohn's disease. Crohn's disease is associated with high rates of postoperative recurrence. The aim of the study was to identify, the risk factors of postoperative 'surgical recurrence' after the first resection for Crohn's disease. Methodology:We report a retrospective study from January 1998 to September 2010 that studied 226 patients originated only from Tunisia (in North Africa), operated on for MC. We had been interested to the risk factor of surgical recurrence of Crohn's disease.Results: Mean age was 33 years. The average time between the onset of the disease and the surgical procedure was 31 months. The diagnosis of CD was established preoperatively in 213 patients (94%). The diagnosis was made intraoperatively because of an acute complication in 5 cases (2.2%) and postoperatively in 8 cases (3.5%). The most common location was the ileocecal junction in 184 cases (81.4%). The most common type of lesion was the mixed form (stricture and fistula) in 123 cases (54.4%). Operative mortality was 0.04% (n=1). Specific morbidity was 8.4% (n=19). In long term, a surgical recurrence was noted in 18 patients (8%). In multivariate analysis, independent risk factors for recurrence were: smoking (p=0.012, ORs=3.57) and post-operative medical treatment (p=0.05, ORs=2.6). Conclusion:Our series is unique for a lower rate of the postoperative recurrence (8%). The two risk factors of recurrence are smoking and the necessity of postoperative medical prophylaxis.

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“…A meta‐analysis by Simillis et al [32] described how patients with a penetrating phenotype may have increased postoperative clinical and surgical recurrence rates, although significant heterogeneity among the 13 studies was observed. Higher symptomatic recurrence and earlier reintervention rates in patients with a perforating phenotype have been noted in more recent studies [33, 34].…”

Section: Resultsmentioning

confidence: 84%

“…A consensus exists in the literature regarding tobacco use [35][36][37]120], penetrating (fistulating B1-type) disease [32][33][34], and the presence of specific NOD2/CARD15 mutations [42][43][44][45][46][47][48][49][50]121] as risk factors in postsurgical recurrence. Interestingly, despite the recent advances in our understanding of the genetic basis of CD, the effect of prior family history of CD remains an area in which opposing conclusions have been drawn in the literature to date [28][29][30][31].…”

Section: Factors Predisposing To Recurrencementioning

confidence: 99%