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Early versus late surgery in patients with intestinal Behçet disease.

 Yoon Suk Jung  ;  Sung Pil Hong  ;  Tae Il Kim  ;  Won Ho Kim  ;  Jae Hee Cheon 
 DISEASES OF THE COLON & RECTUM, Vol.55(1) : 65-71, 2012 
Journal Title
Issue Date
Adult ; Behcet Syndrome/surgery* ; Cohort Studies ; Female ; Humans ; Intestinal Diseases/surgery* ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Recurrence ; Reoperation ; Retrospective Studies ; Time Factors ; Treatment Outcome
Intestinal Behçet disease ; Early surgery ; Late surgery ; Recurrence ; Reoperation
BACKGROUND: To date, no studies have been conducted to evaluate the potential benefits of early surgery in patients with intestinal Behçet disease.

OBJECTIVE: We investigated the long-term clinical outcomes in patients with intestinal Behçet disease first diagnosed at surgery ("early surgery") compared with those requiring surgical resection during the course of the disease ("late surgery").

DESIGN: This is a retrospective cohort study.

SETTINGS: This study was conducted at a single tertiary academic medical center.

PATIENTS: We reviewed the medical records of 272 consecutive patients with intestinal Behçet disease between March 1986 and August 2010.

MAIN OUTCOME MEASURES: The cumulative probabilities of clinical recurrence and reoperation after operation were the main outcomes measures.

RESULTS: Forty of 272 patients were first diagnosed with intestinal Behçet disease at surgery (early surgery); the remaining 232 were diagnosed clinically, with 62 undergoing surgery during their follow-up after clinical diagnosis (late surgery). The cumulative probabilities of postoperative clinical recurrence and reoperation were significantly lower in the early-surgery group than in the late-surgery group (p = 0.045 and p = 0.003). In multivariate analysis, early surgery was the only independent factor significantly associated with a reduced probability of reoperation (HR 0.26; 95% CI 0.10-0.71; p = 0.008). However, when we analyzed only the patients who underwent surgery because of chronic symptoms, early surgery was not associated with lower cumulative clinical recurrence and reoperation rates (p = 0.896 and p = 0.492).

LIMITATIONS: We analyzed the clinical characteristics retrospectively, and the number of patients was insufficient to reach a decisive conclusion.

CONCLUSIONS: : According to the current study, the patients with intestinal Behçet disease undergoing early surgery showed better prognoses in comparison with those undergoing late surgery. Early surgery may represent a valid approach in the initial management of the patients with intestinal Behçet disease, at least in the subset of the patients with acute symptoms.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Jung, Yoon Suk(정윤숙)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
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