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KMID : 0988920140120020117
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Intestinal Research
2014 Volume.12 No. 2 p.117 ~ p.123
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Clinical and Endoscopic Recurrence after Surgical Resection in Patients with Crohn’s Disease
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Lee Yang-Woon
Lee Kang-Moon
Chung Woo-Chul
Park Chang-Nyol
Sung Hea-Jung
Oh You-Suk
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Abstract
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Background/Aims: The natural history of Crohn’s disease (CD) is characterized by a remitting and relapsing course and aconsiderable number of patients ultimately require bowel resection. Moreover, postoperative recurrence is very common.Relatively few studies have investigated the postoperative recurrence of CD in Korea. The aim of the current study was to assesspostoperative recurrence rates ? both clinical and endoscopic ? in CD as well as factors influencing postoperative recurrence.
Methods: Electronic medical records of patients who underwent surgery due to CD were reviewed and analyzed. Patients withincomplete surgical resection, a follow-up period of less than a year, and a history of strictureplasty or perianal surgery wereexcluded.
Results: Of 112 CD patients, 39 patients had history of bowel resection, and 34 patients met the inclusion criteria.Among them, 26 were male (76%) and the mean age of onset was 32.8 years. The mean follow-up period after operation was65.4 months. Cumulative clinical recurrence rates were 8.8%, 12.5%, and 33.5% at 12, 24, and 48 months, respectively. Use of immunomodulatorsfor prophylaxis was the only predictor of clinical recurrence in univariate analysis (P =0.042). Of 21 patientswho had undergone follow-up colonoscopy after surgery, cumulative endoscopic recurrence rates were 33.3%, 42.9%, and66.1% at 6, 12, and 24 months, respectively. No significant predicting factor for endoscopic recurrence was detected.
Conclusions:Postoperative recurrence rates in Korean patients with CD are high, and endoscopic recurrence rates are comparableto those reported from Western studies. Appropriate medical prophylaxis seems to be important for preventing postoperativerecurrence in CD. (Intest Res 2014;12:117-123)
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KEYWORD
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Postoperative recurrence, Crohn’s disease, Endoscopic recurrence
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