Annals of Coloproctology

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The Clinical Features and Predictive Risk Factors for Reoperation in Patients With Perianal Crohn Diseases; A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group: Jae Bum Lee, Seo-Gue Yoon, Kyu Joo Park, Kang Young Lee, Dae Dong Kim, Sang Nam Yoon, Chang Sik Yu; Ann Coloproctol. 2015;31(5):176-181. Published online October 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.5.176

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Purpose

Perianal lesions are common in Crohn disease, but their clinical course is unpredictable. Nevertheless, predicting the clinical course after surgery for perianal Crohn disease (PCD) is important because repeated operations may decrease patient's quality of life. The aim of this study was to predict the risk of reoperation in patients with PCD.

Methods

From September 1994 to February 2010, 377 patients with PCD were recruited in twelve major tertiary university-affiliated hospitals and two specialized colorectal hospitals in Korea. Data on the patient's demographics, clinical features, and surgical outcomes were analyzed.

Results

Among 377 patients, 227 patients were ultimately included in the study. Among the 227 patients, 64 patients underwent at least one reoperation. The median period of reoperation following the first perianal surgery was 94 months. Overall 3-year, 5-year, and 10-year cumulative rates of reoperation-free individuals were 68.8%, 61.2%, and 50.5%, respectively. In multivariate analysis (Cox-regression hazard model), reoperation was significantly correlated with an age of onset less than 20 years (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.07-3.48; P = 0.03), history of abdominal surgery (HR, 1.99; 95% CI, 1.08-3.64; P = 0.03), and the type of surgery. Among types of surgery, fistulotomy or fistulectomy was associated with a decreased incidence of reoperation in comparison with incision and drainage (HR, 0.19; 95% CI, 0.09-0.42; P < 0.001).

Conclusion

Young age of onset and a history of abdominal surgery were associated with a high risk of reoperation for PCD, and the risk of reoperation were relatively low in fistulotomy or fistulectomy procedures.

Citations

Citations to this article as recorded by

A nanofiber-hydrogel composite improves tissue repair in a rat model of Crohn’s disease perianal fistulas
Ling Li, Zhi-Cheng Yao, Alyssa Parian, Yueh-Hsun Yang, Jeffrey Chao, Jason Yin, Kevan J. Salimian, Sashank K. Reddy, Atif Zaheer, Susan L. Gearhart, Hai-Quan Mao, Florin M. Selaru
Science Advances.2023;[Epub] CrossRef
Predictors of reoperation for perianal fistula in Crohn's disease
Kwangwoo Nam, Won Beom Jung, Seung Bum Lee, Jae Seung Soh, Song Soo Yang, Seok Won Jung
Journal of Digestive Diseases.2021; 22(6): 334. CrossRef
Perianal and Luminal Relapse Following Perianal Surgical Intervention in Crohn’s Disease
Feihong Deng, Pianpian Xia, Zengrong Wu, Hejun Zhou, Xuehong Wang
International Journal of General Medicine.2021; Volume 14: 3387. CrossRef
Predictors of Perianal Fistula Relapse in Crohn’s Disease
Audrey Malian, Pauline Rivière, Dominique Bouchard, François Pigot, Marianne Eléouet-Kaplan, Charlotte Favreau-Weltzer, Florian Poullenot, David Laharie
Inflammatory Bowel Diseases.2020; 26(6): 926. CrossRef
Predictors of Perianal Fistula Relapse in Crohn’s Disease
Dana J Lukin
Inflammatory Bowel Diseases.2019;[Epub] CrossRef
Management of Perianal Fistulas in Crohn’s Disease
Steffen Seyfried, Alexander Herold
Visceral Medicine.2019; 35(6): 338. CrossRef
Surgical management of fistulating perianal Crohn's disease: a UK survey
M. J. Lee, N. Heywood, P. M. Sagar, S. R. Brown, N. S. Fearnhead
Colorectal Disease.2017; 19(3): 266. CrossRef
Risk of Repeat Surgery for Perianal Crohn Disease
Doo Han Lee
Annals of Coloproctology.2015; 31(5): 169. CrossRef

Risk Factors for Repeat Abdominal Surgery in Korean Patients with Crohn's Disease: A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group: Kil Yeon Lee, Chang Sik Yu, Kang Young Lee, Yong Beom Cho, Kyu Joo Park, Gyu-Seog Choi, Sang Nam Yoon, Hanna Yoo; J Korean Soc Coloproctol. 2012;28(4):188-194. Published online August 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.4.188

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26 Download
8 Citations

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Purpose

The purpose of this study was to assess the risk factors for repeated abdominal surgery in Crohn's disease (CD) patients after the first abdominal surgery. Prior studies have tried to identify the risk factors for postoperative recurrence in CD patients, but the results of the studies have been inconsistent. Furthermore, few data on the risk factors for repeated abdominal surgery are available.

Methods

Clinical data on CD patients who underwent abdominal surgery from January 2000 to December 2009 were collected from seventeen university hospitals and one colorectal clinic. Data from a total of 708 patients were analyzed to find the risk factors for repeated abdominal surgery in CD patients. The mean follow-up period was 72 months.

Results

The risk of repeated abdominal surgery was 3 times higher in young patients (below 16 years old) than in older patients (odds ratio [OR], 3.056; 95% confidence interval [CI], 1.021 to 9.150); P = 0.046). Stricturing behavior at diagnosis was also a risk factor for repeated abdominal surgery (OR, 2.438; 95% CI, 1.144 to 5.196; P = 0.021). Among operative indications, only intra-abdominal abscess was associated with repeated abdominal surgery (OR, 2.393; 95% CI, 1.098 to 5.216; P = 0.028). Concerning type of operation, an ileostomy might be a risk factor for repeated abdominal surgery (OR, 11.437; 95% CI, 1.451 to 90.124; P = 0.021). Emergency surgery (OR, 4.994; 95% CI, 2.123 to 11.745; P < 0.001) and delayed diagnosis after surgery (OR, 2.339; 95% CI, 1.147 to 4.771; P = 0.019) also increased the risk of repeated abdominal surgery.

Conclusion

Young age (below 16 years), stricturing behavior, intra-abdominal abscess, emergency surgery, and delayed diagnosis after surgery were identified as possible risk factors for repeated abdominal surgery in CD patients.

Citations

Citations to this article as recorded by

Therapeutic strategies in Crohn’s disease in an emergency surgical setting
Maria Michela Chiarello, Gilda Pepe, Valeria Fico, Valentina Bianchi, Giuseppe Tropeano, Gaia Altieri, Giuseppe Brisinda
World Journal of Gastroenterology.2022; 28(18): 1902. CrossRef
Risk Factors for Postoperative Recurrence in Korean Patients with Crohn’s Disease
Sung Bae Kim, Jae Hee Cheon, Jae Jun Park, Eun Soo Kim, Seong Woo Jeon, Sung-Ae Jung, Dong Il Park, Chang Kyun Lee, Jong Pil Im, You Sun Kim, Hyun Soo Kim, Jun Lee, Chang Soo Eun, Jeong Mi Lee, Byung Ik Jang, Geom Seog Seo
Gut and Liver.2020; 14(3): 331. CrossRef
Prevalence and factors associated with re-laparotomy among patients operated in Debre-Markos referral hospital, north west Ethiopia: Retrospective cross-sectional study
Yeneabat Birhanu, Debrework Tesgera, Henok Biresaw Netsere, Nurhusien Nuru
International Journal of Africa Nursing Sciences.2020; 13: 100249. CrossRef
Comparison of missing data methods in clustered survival data using Bayesian adaptive B-Spline estimation
Hanna Yoo, Jae Won Lee
Communications for Statistical Applications and Methods.2018; 25(2): 159. CrossRef
Patients with perianal Crohn's disease have poor disease outcomes after primary bowel resection
Yoo Min Han, Ji Won Kim, Seong‐Joon Koh, Byeong Gwan Kim, Kook Lae Lee, Jong Pil Im, Joo Sung Kim, Hyun Chae Jung
Journal of Gastroenterology and Hepatology.2016; 31(8): 1436. CrossRef
The Clinical Features and Predictive Risk Factors for Reoperation in Patients With Perianal Crohn Diseases; A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group
Jae Bum Lee, Seo-Gue Yoon, Kyu Joo Park, Kang Young Lee, Dae Dong Kim, Sang Nam Yoon, Chang Sik Yu
Annals of Coloproctology.2015; 31(5): 176. CrossRef
Crohn's disease in Korea: past, present, and future
Kang-Moon Lee, Ji Min Lee
The Korean Journal of Internal Medicine.2014; 29(5): 558. CrossRef
Clinical and Endoscopic Recurrence after Surgical Resection in Patients with Crohn's Disease
Yang Woon Lee, Kang-Moon Lee, Woo Chul Chung, Chang Nyol Paik, Hea Jung Sung, You Suk Oh
Intestinal Research.2014; 12(2): 117. CrossRef

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