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Risk Factors Regarding the Need for a Second Operation in Patients with Crohn’s Disease

Avidan B.a, d · Sakhnini E.a · Lahat A.a · Lang A.a, d · Koler M.b, d · Zmora O.c, d · Bar-Meir S.a, d · Chowers Y.a, d
Departments of aGastroenterology, bSurgery C and cSurgery B, Chaim Sheba Medical Center, Tel-Hashomer, and dSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Digestion 2005;72:248–253 (DOI:10.1159/000089960)

Abstract

Background/Aims: The majority of Crohn’s disease patients undergo surgery. However, the factors that predict post-operative recurrence remain controversial. The aim of the present study was to shed light on the potential predictors of such recurrence. Methods: 86 patients who underwent operative procedures for Crohn’s disease were retrospectively studied. Recurrence was defined as the need for a second operation. Life table and multivariate analysis were performed to find the predictors of recurrence. Results: In 26/86 (30%) of the patients, post-operative recurrence was diagnosed within a mean of 42 months of the follow-up. Logistic regression analysis revealed that smoking (OR 3.69, 95% CI 2.06–11.52) and perforating disease (OR 4.09, 95% CI 1.31–12.65) were associated with a risk of recurrence. However, survival analysis showed that only perforating disease was associated with an early post-operative recurrence (log-rank test, p < 0.001). Neither resected surgical specimen characteristics, nor the duration and the location of the disease were found to predict the need for a second operation. Conclusion: The risk for Crohn’s disease patients who undergo surgery is related to the presence of perforating disease and smoking, which predict the need for a second operation. The former is associated with an even earlier recurrence.

 

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