Avidan B, Sakhnini E, Lahat A, Lang A, Koler M, Zmora O, Bar-Meir S, Chowers Y
Department of Gastroenterology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Digestion. 2005;72(4):248-53. doi: 10.1159/000089960. Epub 2005 Nov 25.
BACKGROUND/AIMS: The majority of Crohn's disease patients undergo surgery. However, the factors that predict post-operative recurrence remain controversial. The aim of the present study was to shed light on the potential predictors of such recurrence.
86 patients who underwent operative procedures for Crohn's disease were retrospectively studied. Recurrence was defined as the need for a second operation. Life table and multivariate analysis were performed to find the predictors of recurrence.
In 26/86 (30%) of the patients, post-operative recurrence was diagnosed within a mean of 42 months of the follow-up. Logistic regression analysis revealed that smoking (OR 3.69, 95% CI 2.06-11.52) and perforating disease (OR 4.09, 95% CI 1.31-12.65) were associated with a risk of recurrence. However, survival analysis showed that only perforating disease was associated with an early post-operative recurrence (log-rank test, p < 0.001). Neither resected surgical specimen characteristics, nor the duration and the location of the disease were found to predict the need for a second operation.
The risk for Crohn's disease patients who undergo surgery is related to the presence of perforating disease and smoking, which predict the need for a second operation. The former is associated with an even earlier recurrence.
背景/目的：大多数克罗恩病患者需要接受手术治疗。然而，预测术后复发的因素仍存在争议。本研究旨在阐明此类复发的潜在预测因素。
对86例接受克罗恩病手术治疗的患者进行回顾性研究。复发定义为需要进行二次手术。采用生命表法和多变量分析来寻找复发的预测因素。
在86例患者中的26例（30%），术后复发在平均随访42个月内被诊断出来。逻辑回归分析显示，吸烟（比值比3.69，95%可信区间2.06 - 11.52）和穿孔性疾病（比值比4.09，95%可信区间1.31 - 12.65）与复发风险相关。然而，生存分析表明只有穿孔性疾病与术后早期复发相关（对数秩检验，p < 0.001）。未发现切除的手术标本特征、疾病持续时间和部位可预测二次手术的需求。
接受手术的克罗恩病患者的复发风险与穿孔性疾病和吸烟有关，这两者可预测二次手术的需求。前者与更早的复发相关。
