Presence of granulomas is associated with recurrence after surgery for Crohn's disease: experience of a surgical unit.
BACKGROUND
The determinants for recurrence of Crohn's disease remain controversial. Eight factors that might predict recurrence were studied in 130 patients operated on for Crohn's disease over a 24-year period.


METHODS
Separate survival curves were estimated for each variable. A multivariate analysis was then carried out in which several selected explanatory variables were included simultaneously in a proportional hazards regression model.


RESULTS
Operation for recurrent disease was necessary in 36 patients. Univariate analysis revealed a highly significant relationship between the presence of granulomas and subsequent recurrence (P = 0.003). There was a trend towards increased recurrence in patients with ileocolonic disease and segmental colectomy (P = 0.11 and P = 0.1 respectively). Age, sex, length of history, indication for operation and affected lines of transection were not associated with recurrence. After multivariate analysis, the association of granulomas with recurrence remained significant (P = 0.03). This association persisted when death was regarded as a treatment failure (P = 0.02).


CONCLUSIONS
The presence of granulomas in patients with Crohn's disease is significantly associated with recurrence.
Anseline
P F
PF
Department of Surgery, Royal Newcastle Hospital, University of Newcastle, New South Wales, Australia.
Wlodarczyk
J
J
Murugasu
R
R
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003082:Colectomy; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006099:Granuloma / Q000150:complications*; D006801:Humans; D007077:Ileal Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome