Operative and environmental risk factors for recurrence of Crohn's disease

This retrospective study determined whether a hand-sewn or stapled anastomo sis leads to a greater recurrence rate in patients undergoing ileocecal res ection for terminal ileal Crohn's disease. The effects of oral contraceptiv e use, smoking, and age at onset of disease were also examined. Ninety-two patients with Crohn's disease of the terminal ileum whose first operation w as an ileocecal resection (terminal ileum and right colon up to but not inc luding the hepatic flexure) were studied for symptomatic and operative recu rrence. The symptomatic recurrence rates were 15% at 1 year, 31% at 2 years , and 45% at 3 years. The operative recurrence rates were 6% at I year, 14% at 2 years, and 32% at 3 years. The type of anastomosis, whether hand-sewn or stapled, did not affect the rates of symptomatic (P = 0.3) or operative (P = 0.6) recurrence. After the initial resection smoking affected bath sy mptomatic (P = 0.03, risk ratio = 2.380) and operative (P = 0.041, risk rat io = 3.13) recurrence, but there was no effect of age at onset of disease o r use of the birth control pill.