Factors affecting the incidence of early endoscopic recurrence after ileocolonic resection for Crohn's disease: a multicentre observational study

Ivan Folchini De Barcelos, Paulo G ustavo Kotze, Antonino Spinelli, Y. Suzuki, Fabio Vieira Teixeira, Idblan Carvalho De Albuquerque, Rogerio Saad-Hossne, Lorete Maria Da Silva Kotze, T. Yamamoto

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: Early endoscopic recurrence is frequently observed in patients following resection for Crohn's disease (CD). However, factors affecting the incidence of an early postoperative endoscopic recurrence (EPER) have not been fully determined. The aim of this study was to evaluate risk factors for EPER after ileocolonic resection for CD. Method: This was a retrospective, international multicentre study, in which 127 patients with a first ileocolonoscopy conducted between 6 and 12 months after ileocolonic resection for CD were included. Endoscopic recurrence was defined as a Rutgeerts score of ≥ i2. The following variables were investigated as potential risk factors for EPER: gender, age at surgery, location and behaviour of CD, smoking, concomitant perianal lesions, preoperative use of steroids, immunomodulators and biologics, previous resection, blood transfusion, surgical procedure (open vs laparoscopic approach), length of resected bowel, type of anastomosis (side-to-side vs end-to-end), postoperative complications, granuloma and postoperative biological therapy. Variables related to the patient, disease and surgical procedure were investigated as potential risk factors for EPER, with univariate and multivariate (logistic regression) analyses. Results: 43/127 (34%) patients had EPER at the time of the first postoperative ileocolonoscopy. In univariate analysis, only preoperative steroid use was significantly associated with a higher rate of EPER [21/45 patients (47%) on steroids and 22/82 patients (27%) without steroids (P = 0.04)]. In multivariate analysis, only preoperative steroid use was a significant independent risk factor for EPER (odds ratio 3.28, 95% confidence interval: 1.30–8.28; P = 0.01). Conclusions: This study found that only preoperative steroid use was a significant risk factor for EPER after ileocolonic resection for CD. Prospective studies are necessary to evaluate precisely the impact of perioperative medications on EPER rates.

Original languageEnglish
Pages (from-to)O39-O45
JournalColorectal Disease
Volume19
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

Keywords

  • Crohn's disease
  • endoscopic recurrence
  • ileocolonic resection
  • postoperative recurrence
  • risk factor

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Factors affecting the incidence of early endoscopic recurrence after ileocolonic resection for Crohn's disease: a multicentre observational study'. Together they form a unique fingerprint.

Cite this