Y. Raab et al., FACTORS INFLUENCING RECURRENCE IN CROHNS-DISEASE - AN ANALYSIS OF A CONSECUTIVE SERIES OF 353 PATIENTS TREATED WITH PRIMARY SURGERY, Diseases of the colon & rectum, 39(8), 1996, pp. 918-925
PURPOSE: This study was undertaken to investigate the factors that inf
luenced the risk of symptomatic recurrence in patients with Crohn's di
sease who were treated with primary resective surgery. METHODS: Data r
egarding age, gender, time from diagnosis to surgery, medication, preo
perative infectious complications, laboratory values, emergency/electi
ve surgery, location and extent of disease, and resection margins were
analyzed in relation to recurrence in 353 patients who were undergoin
g a ''curative'' resection in 1969 to 1986. RESULTS: Univariate analys
es showed a higher risk of recurrence in women with ileal and ileocolo
nic disease than in men (P < 0.05), in patients with ileocolonic disea
se compared with those with isolated ileal disease (P < 0.05), and in
ileal disease patients with an increased disease extent (P < 0.05). In
a multivariate analysis performed on patients with ileal disease, inc
reased disease extent, limited resection on the colonic side, and refe
rral from other hospitals were three independent variables that indica
ted an increased risk of recurrence (P < 0.05). Length of disease-free
resection margins did not influence the risk of recurrence either in
univariate or in multivariate analysis (P > 0.05). CONCLUSIONS: Diseas
e extent has prognostic value regarding the risk of symptomatic recurr
ence in Crohn's disease, whereas the length of resection margins does
not influence the risk of relapse. These results favor a conservative
approach, particularly in patients with extensive disease.