Factors affecting the postoperative recurrence of Crohn's disease. New controversies with one centre's experience

Post-operative recurrence in Crohn's disease. Critical analysis of potential risk factors. An update

“…3 The trials that correlate the rate of POR with postoperative complications, are not many. 34,44,69,74 Some Authors, among these Scarpa et al and Holzheimer et al, believe that the occurrence of postoperative complications is associated with a higher rate of recurrence 69,74 Other studies, such as Poggioli et al prospective audit, do not show any correlation. 34 …”

“…62 Vigo et al in their study showed that when granuloma was found in the specimen the risk of POR became 2.2 times higher, being nearly statistically significant with a CI 95%: 0.92e5.27. 44 Still others believe that the presence of granuloma in the specimen would increase the incidence of recurrences in the anastomosis in patients with ileo-colonic localization of CD. 33 On the other hand other Authors, as Chambers et al, report a lower recurrence rate.…”

“…In conclusion, blood transfusions do not have a protective effect on POR. 44,78 Histopathology Plexitis Recent data suggest that the presence of myenteric plexitis in the resection margins may be a relevant predictor of POR. In their study, whose aim was to assess the predictive value of plexitis for early clinical CD recurrence after surgical resection, Sokol et al reported that early clinical recurrence of CD occurred in 28.1% of patients and that submucosal plexitis (with >or ¼3 mastocytes) were predictive for clinical POR (HR ¼ 1.87; 95% CI 1.00 to 3.46; p ¼ 0.048).…”

“…14,22,33,34,42,136 Cigarette smoking is a real predictive factor in increasing the risk of POR. 26,36,37,39,40,44,48,136,137 Smoking significantly increases the risk in heavy smokers and especially in females. The effect of smoking is dose-dependent.…”