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Risk Factors for Postoperative Recurrence in Korean Patients with Crohn's Disease

Authors
 Sung Bae Kim  ;  Jae Hee Cheon  ;  Jae Jun Park  ;  Eun Soo Kim  ;  Seong Woo Jeon  ;  Sung-Ae Jung  ;  Dong Il Park  ;  Chang Kyun Lee  ;  Jong Pil Im  ;  You Sun Kim  ;  Hyun Soo Kim  ;  Jun Lee  ;  Chang Soo Eun  ;  Jeong Mi Lee  ;  Byung Ik Jang  ;  Geom Seog Seo 
Citation
 GUT AND LIVER, Vol.14(3) : 331-337, 2020-05 
Journal Title
GUT AND LIVER
ISSN
 1976-2283 
Issue Date
2020-05
MeSH
Adolescent ; Adult ; Crohn Disease / epidemiology ; Crohn Disease / pathology* ; Crohn Disease / surgery* ; Endoscopy, Gastrointestinal / statistics & numerical data* ; Female ; Humans ; Incidence ; Male ; Postoperative Complications / epidemiology* ; Postoperative Complications / etiology* ; Postoperative Period ; Recurrence ; Republic of Korea / epidemiology ; Risk Factors ; Treatment Outcome ; Young Adult
Keywords
Crohn disease ; Recurrence ; Risk factors ; Surgery ; Thiopurine
Abstract
Background/aims: A considerable number of patients with Crohn's disease still need intestinal resection surgery. Postoperative recurrence is an important issue in Crohn's disease management, including the selection of high-risk patients. Eastern Asian patients showed several differences from Caucasian patients. Therefore, we investigated the postoperative surgical recurrence outcome and identified risk factors in Korean patients.

Methods: Clinical data of 372 patients with Crohn's disease who underwent first intestinal resection between January 2004 and August 2014 at 14 hospitals in Korea were retrospectively reviewed.

Results: Over the follow-up period, 50 patients (17.1%) showed surgical recurrence. The cumulative surgical recurrence rate was 6.5% at 1 year and 15.4% at 7 years. Age under 16 (p=0.011; hazard ratio [HR], 5.136; 95% confidence interval [CI], 1.576 to 16.731), colonic involvement (p=0.023; HR , 2.011; 95% CI, 1.102 to 3.670), and the presence of perianal disease at surgery (p=0.008; HR, 2.239; 95% CI, 1.236 to 4.059) were independent risk factors associated with surgical recurrence. Postoperative thiopurine treatment (p=0.002; HR, 0.393; 95% CI, 0.218 to 0.710) was a protective factor for surgical recurrence.

Conclusions: Among the disease characteristics at surgery, younger age, colonic location, and perianal lesions were independent risk factors for surgical recurrence. Postoperative thiopurine treatment significantly reduced the incidence of surgical recurrence.
Files in This Item:
T999202268.pdf Download
DOI
10.5009/gnl19085
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jae Jun(박재준)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/183953
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