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KMID : 1188320200140030331
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Gut and Liver
2020 Volume.14 No. 3 p.331 ~ p.337
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Risk Factors for Postoperative Recurrence in Korean Patients with Crohn’s Disease
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Kim Sung-Bae
Cheon Jae-Hee
Park Jae-Jun
Kim Eun-Soo
Jeon Seong-Woo
Jung Sung-Ae
Park Dong-Il
Lee Chang-Kyun
Im Jong-Pil
Kim You-Sun
Kim Hyun-Soo
Lee Jun
Eun Chang-Soo
Lee Jeong-Mi
Jang Byung-Ik
Seo Geom-Seog
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Abstract
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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.
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KEYWORD
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Crohn disease, Recurrence, Surgery, Risk factors, Thiopurine
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