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Surgical recurrence in Crohn’s disease: a comparison between different types of bowel resections

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

To compare recurrence frequency and location between different types of bowel resections in Crohn’s disease patients.

Methods

This was a retrospective study of consecutive patients undergoing bowel resection for Crohn’s disease between 2006 and 2016. Type of primary operation was recorded and grouped as ileocolic resection, small bowel resection, segmental colon resection with colocolic anastomosis or colorectal anastomosis, colectomy with ileorectal anastomosis, or end stoma operation. Binary logistic regression was used to compare surgical recurrence frequency between groups. We also investigated how Crohn’s disease location at reoperations was related to the primary bowel resection type.

Results

Altogether, 218 patients with a median follow-up of 4.7 years were included in our study. Reoperation was performed in 42 (19.3%) patients. The risk of reoperation using the ileocolic resection group as reference was the following: small bowel resection (odds ratio (OR) 2.95, 95% confidence interval (CI) 1.01–8.66; P = 0.049), segmental colon resection with colocolic or colorectal anastomosis (OR 6.20, 95% CI 2.04–18.87; P = 0.001), colectomy with ileorectal anastomosis (OR 26.57, 95% CI 2.59–273.01; P = 0.006), and end stoma operation (OR 4.62, 95% CI 1.90–11.26; P = 0.001). In case of surgical recurrence, the reoperation type and location correlated with the primary bowel resection type.

Conclusions

Reoperation frequency in Crohn’s disease is lower after ileocolic resection than after other types of bowel resections. Surgical recurrence in Crohn’s disease tends to maintain the disease location of the primary operation. One third of Crohn’s patients undergoing an end stoma operation will still need new bowel resections due to recurrence.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Helsinki University Hospital, P.O. Box 340, 00029 HUS, Helsinki, Finland

    Gisele Aaltonen, Monika Carpelan-Holmström, Ilona Keränen & Anna Lepistö

Authors
  1. Gisele Aaltonen
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  2. Monika Carpelan-Holmström
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  3. Ilona Keränen
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  4. Anna Lepistö
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Corresponding author

Correspondence to Gisele Aaltonen.

Ethics declarations

All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration comparable ethical standards. For this type of study formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.

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Aaltonen, G., Carpelan-Holmström, M., Keränen, I. et al. Surgical recurrence in Crohn’s disease: a comparison between different types of bowel resections. Int J Colorectal Dis 33, 473–477 (2018). https://doi.org/10.1007/s00384-018-2995-9

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  • DOI: https://doi.org/10.1007/s00384-018-2995-9

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