Factors That Determine Risk for Surgery in Pediatric Patients With Crohn's Disease

Risk factors for initial surgery in patients with Crohn’s disease in Central China

“…Some studies have found that age, gender, disease localization, disease behavior, smoke and medical therapy had an impact on surgical intervention, but these findings have not been confirmed by other studies [4][5][6][7][8][9][10]. Our previous epidemiological studies showed that there is an increasing prevalence of CD in China, with a substantial incidence in recent years.…”

Can We Change the Natural History of Crohn's Disease with Early Immunomodulation?

“…While exposure to corticosteroid therapy was associated with a significantly increased risk of surgery (OR 2.98; 95% CI 1.64-5.41; p < 0.01), azathioprine treatment halved the risk (OR 0.51; 95% CI 0.33-0.78; p < 0.01). By contrast, a North American observational study of a newly diagnosed inception cohort diagnosed between 2002 and 2008 identified no effect of early immunomodulation on pediatric CD surgery [14]. Cumulative bowel surgery rates in this cohort were 3.4% at 1 year and 13.8% at 5 years after diagnosis.…”

Management of Crohn's disease

“…52 In one retrospective study, out of 69 patients who required surgery, 58% underwent right hemi-colectomy, 3% subtotal colectomy, 12% stoma formation and 14% surgery for perianal disease. Patients with late-onset paediatric, severe/extensive or stricturing/penetrating CD have increased the risk for bowel surgery.…”

“…59 Strictures particularly involving the terminal ileum/ileocaecal valve are a common indication for CD surgery. 52 Limited resections or stricturoplasty are considered best practice to preserve gut length and prevent short bowel syndrome.…”