Risk factors for surgery and recurrence in 907 patients with primary ileocaecal Crohn's disease

Background: Previous studies on risk factors for resection and postoperativ e recurrence in Crohn's disease have given inconclusive results. The aim of this study was to assess the risk for resection and postoperative recurren ce in the treatment of ileocaecal Crohn's disease and to define factors aff ecting the course of the disease. Methods: A population-based cohort of 907 patients with primary ileocaecal Crohn's disease was reviewed retrospectively. Results: Resection rates were 61, 77 and 83 per cent at 1, 5 and 10 years r espectively after the diagnosis. Relapse rates were 28 and 36 per cent 5 an d 10 years after the first resection. A younger age at diagnosis resulted i n a low resection rate. The presence of perianal Crohn's disease and long r esection segments increased the incidence of recurrence, and resection for a palpable mass and/or abscess decreased the recurrence rate. A decrease in recurrence rate during the study period (1955-1989) was observed. Conclusion: In ileocaecal Crohn's disease the probability of resection is h igh and the risk of recurrence moderate. Crohn's disease in childhood carri es a lower risk of primary resection. Perianal disease and extensive ileal resection increase the risk of recurrence.