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1 "Hyun Chae Jung"
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Original Article
Long-term Outcomes and Risk Factors for Reoperation After Surgical Treatment for Gastrointestinal Crohn Disease According to Anti-tumor Necrosis Factor-α Antibody Use: 35 Years of Experience at a Single Institute in Korea
Sang Mok Lee, Eon Chul Han, Seung-Bum Ryoo, Heung-Kwon Oh, Eun Kyung Choe, Sang Hui Moon, Joo Sung Kim, Hyun Chae Jung, Kyu Joo Park
Ann Coloproctol. 2015;31(4):144-152.   Published online August 31, 2015
DOI: https://doi.org/10.3393/ac.2015.31.4.144
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  • 6 Web of Science
  • 7 Citations
AbstractAbstract PDF
Purpose

Crohn disease is characterized by high rates of recurrence and reoperations. However, few studies have investigated long-term surgical outcomes in Asian populations. We investigated risk factors for reoperation, particularly those associated with anti-tumor necrosis factor-α (anti-TNF-α) antibody use, and long-term follow-up results.

Methods

We reviewed the records of 148 patients (100 males and 48 females) who underwent surgery for gastrointestinal Crohn disease and retrospectively analyzed long-term outcomes and risk factors.

Results

The mean age at diagnosis was 28.8 years. Thirty-eight patients (25.7%) received monoclonal antibody treatment before reoperation. A small bowel and colon resection was most commonly performed (83 patients, 56.1%). The median follow-up was 149 months, during which 47 patients underwent reoperation. The median interval between the primary and the secondary surgeries was 65 months, with accumulated reoperation rates of 16.5%, 31.8%, and 57.2% after 5, 10, and 15 years, respectively. Obstruction was the most common indication for reoperation (37 patients, 25.0%). In a multivariable analysis, age <17 years at diagnosis (A1) (odds ratio [OR], 2.20; P = 0.023), penetrating behavior (B3) (OR, 4.39; P < 0.001), and no azathioprine use (OR, 2.87; P = 0.003) were associated with reoperation. Anti-TNF-α antibody use did not affect the reoperation rate (P = 0.767).

Conclusion

We showed a high reoperation rate regardless of treatment with anti-TNF-α antibody, which indicates that recurrent surgery is still needed to cure patients with gastrointestinal Crohn diseases. Younger age at primary operation, penetrating behavior, and no azathioprine use were significant factors associated with reoperation for gastrointestinal Crohn disease.

Citations

Citations to this article as recorded by  
  • Inflammatory Bowel Disease Reoperation Rate Has Decreased Over Time If Corrected by Prevalence
    Mafalda Santiago, Fernando Magro, Luís Correia, Francisco Portela, Paula Ministro, Paula Lago, Eunice Trindade, Cláudia Camila Dias
    Clinical and Translational Gastroenterology.2020; 11(9): e00227.     CrossRef
  • Effect of Thiopurine on Potential Surgical Intervention in Crohn’s Disease in Korea: Results from the CONNECT Study
    Hee Man Kim, Jin Woo Kim, Hyun-Soo Kim, Joo Sung Kim, You Sun Kim, Jae Hee Cheon, Won Ho Kim, Byong Duk Ye, Won Moon, Sung Hee Jung, Young-Ho Kim, Dong Soo Han
    Journal of Clinical Medicine.2020; 10(1): 25.     CrossRef
  • Risk factors for postoperative surgical site infections in patients with Crohn’s disease receiving definitive bowel resection
    Song Liu, Ji Miao, Gefei Wang, Meng Wang, Xiuwen Wu, Kun Guo, Min Feng, Wenxian Guan, Jianan Ren
    Scientific Reports.2017;[Epub]     CrossRef
  • Advanced age impacts surgical characteristics and postoperative course in patients with Crohn's disease
    Stanislaus Argeny, Anton Stift, Martina Mittlböck, Amy C. Lord, Svenja Maschke, Mathias Schneeweiß, Stefan Riss
    International Journal of Surgery.2016; 33: 182.     CrossRef
  • Effect of Tripterygium Wilfordii Polyglycoside on Experimental Prostatitis Caused by Ureaplasma Urealyticum in Rats
    Pingnan Shan, Zhiyong Lu, Lihong Ye, Yaqin Fang, Suhong Tan, Guohong Xuan, Jincheng Ru, Liming Mao
    Medical Science Monitor.2016; 22: 3722.     CrossRef
  • Endoscopy-based management decreases the risk of postoperative recurrences in Crohn’s disease
    Anne-Laure Boucher, Bruno Pereira, Stéphanie Decousus, Marion Goutte, Felix Goutorbe, Anne Dubois, Johan Gagniere, Corinne Borderon, Juliette Joubert, Denis Pezet, Michel Dapoigny, Pierre J Déchelotte, Gilles Bommelaer, Anthony Buisson
    World Journal of Gastroenterology.2016; 22(21): 5068.     CrossRef
  • Anti-tumor Necrosis Factor Therapy for Crohn Disease: Friend or Foe to the Surgeon?
    Hungdai Kim
    Annals of Coloproctology.2015; 31(4): 121.     CrossRef
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