Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing 210002, China.
J Gastrointest Surg. 2012 Aug;16(8):1539-47. doi: 10.1007/s11605-012-1902-x. Epub 2012 May 4.
Data on risk factors of postoperative recurrence in patients with Crohn's disease (CD) have shown conflicting results. The aim of this retrospective study is to identify predictors of early symptomatic recurrence of CD after surgical intestinal resection in the Chinese population.
Patients diagnosed as CD who underwent intestinal resection in Jinling Hospital between May 2004 and December 2010 were included in our study. Clinical data of these patients were reviewed. Multivariable survival analysis was performed to elucidate risk factors of early postoperative symptomatic recurrence.
There were a total of 141 CD patients who had at least one previous curative resection for CD under regular follow-up in our unit. Our data indicated disease behavior (95 % CI 1.01-1.70, P = 0.044), smoking habits (95 % CI 1.32-2.84, P = 0.001), indication of perforation (95 % CI 1.09-4.02, P = 0.026), and location of anastomosis (95 % CI 1.09-3.39, P = 0.023) which are, as a result, strong independent predictors of symptomatic recurrence, while the anastomosis type as side-to-side anastomosis (SSA) was significantly associated with a decreased risk of symptomatic recurrence when compared with other anastomosis type (95 % CI 0.26-0.94, P = 0.038). Medical prophylaxes also played a role in the prevention of postoperative symptomatic recurrence.
A smoking habits and perforation indication for surgery at the time of resection are associated with an increased risk of symptomatic recurrence. Anastomosis type with SSA is associated with a reduced risk of symptomatic recurrence. This population-based study supports the concept that environmental factors, disease character, and surgical technique influence the risk of postoperative symptomatic recurrence of CD.
有关克罗恩病（CD）患者术后复发风险因素的数据结果不一。本回顾性研究旨在确定中国人群中接受手术肠切除的 CD 患者术后早期出现症状性复发的预测因素。
纳入 2004 年 5 月至 2010 年 12 月在我院接受肠切除术的 CD 患者。回顾这些患者的临床资料。采用多变量生存分析阐明术后早期症状性复发的风险因素。
本单位共有 141 例 CD 患者在规律随访中至少接受过一次针对 CD 的治愈性切除术。我们的数据表明疾病行为（95%可信区间 1.01-1.70，P=0.044）、吸烟习惯（95%可信区间 1.32-2.84，P=0.001）、穿孔的适应证（95%可信区间 1.09-4.02，P=0.026）和吻合口位置（95%可信区间 1.09-3.39，P=0.023）是症状性复发的独立强预测因素，而与其他吻合口类型相比，侧侧吻合术（SSA）的吻合口类型与症状性复发风险降低显著相关（95%可信区间 0.26-0.94，P=0.038）。预防性使用药物也在预防术后症状性复发中发挥作用。
手术时的吸烟习惯和穿孔适应证与症状性复发风险增加相关。SSA 吻合口类型与症状性复发风险降低相关。这项基于人群的研究支持这样的观点，即环境因素、疾病特征和手术技术影响 CD 术后症状性复发的风险。
