Surgical recurrence rates among patients with Crohn's disease with ileocolic resection remain high, and factors predicting surgical recurrence remain controversial.
Dr Christine Manser and colleagues identified risk and protective factors for repetitive ileocolic resections among patients with Crohn's disease in a large cohort of patients.
Data on 305 patients after first ileocolic resection were retrieved from our cross-sectional and prospective database.
Data were compared between patients with 1 or more than 1 resection.
|Immunomodulators within 1 year after first ileocolic resection was a protective factor|
|Inflammatory Bowel Diseases|
Clinical phenotypes were classified according to the Montreal Classification.
Gender, family history of inflammatory bowel disease, smoking status, type of surgery, immunomodulator, and biological therapy before, parallel to and after first ileocolic resection were analyzed.
The research team found that the mean duration from diagnosis until first ileocolic resection did not differ significantly between the groups, being 6 years in the ileocolic resection group with 1 resection, and 5 years in the ileocolic resection group with more than 1 resection.
Mean time to second ileocolic resection was 7 years.
The researchers found that ileal disease location was a significant risk factor.
A therapy with immunomodulators at time of or within 1 year after first ileocolic resection was a protective factor.
The researchers noted that neither smoking nor gender or family history had a significant impact on surgical recurrence.
Dr Manser's team concludes, "Immunomodulators have a protective impact regarding surgical recurrence after ileocolic resection."
"In contrast, ileal disease location constitutes a significant risk factor for a second ileocolic resection."