Risk factors for surgery and recurrence in 907 patients with primary ileocaecal Crohn's disease

Author:

Bernell O1,Lapidus A2,Hellers G1

Affiliation:

1. Department of Surgery, Huddinge University Hospital, S-141 86 Huddinge, Sweden

2. Department of Gastroenterology, Karolinska Institute, Huddinge University Hospital, S-141 86 Huddinge, Sweden

Abstract

Abstract Background Previous studies on risk factors for resection and postoperative recurrence in Crohn's disease have given inconclusive results. The aim of this study was to assess the risk for resection and postoperative recurrence in the treatment of ileocaecal Crohn's disease and to define factors affecting the course of the disease. Methods A population-based cohort of 907 patients with primary ileocaecal Crohn's disease was reviewed retrospectively. Results Resection rates were 61, 77 and 83 per cent at 1, 5 and 10 years respectively after the diagnosis. Relapse rates were 28 and 36 per cent 5 and 10 years after the first resection. A younger age at diagnosis resulted in a low resection rate. The presence of perianal Crohn's disease and long resection segments increased the incidence of recurrence, and resection for a palpable mass and/or abscess decreased the recurrence rate. A decrease in recurrence rate during the study period (1955–1989) was observed. Conclusion In ileocaecal Crohn's disease the probability of resection is high and the risk of recurrence moderate. Crohn's disease in childhood carries a lower risk of primary resection. Perianal disease and extensive ileal resection increase the risk of recurrence.

Publisher

Oxford University Press (OUP)

Subject

Surgery

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2. Preventing postoperative recurrence of Crohn's disease;Borley;Br J Surg,1997

3. Incidence of Crohn's disease in Stockholm County 1955–1989;Lapidus;Gut,1997

4. Classification of inflammatory bowel disease;Lennard-Jones;Scand J Gastroenterol Suppl,1989

5. Evaluation of survival data and two new rank order statistics arising in its consideration;Mantel;Cancer Chemother Rep,1966

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