Recurrence after segmental resection for colonic Crohn's disease.
BACKGROUND
Segmental colonic resection is commonly performed in patients with colorectal Crohn's disease. The aim of this study was to evaluate the outcome after segmental colonic resection and to define risk factors for re-resection.


METHODS
Consecutive patients who had an initial segmental colonic resection for Crohn's colitis between 1987 and 2000 were evaluated. Patients who underwent ileocolonic resection were excluded. Patient-, disease- and treatment-related variables were assessed as possible risk factors for disease recurrence.


RESULTS
Ninety-one patients (62 women) with a median follow-up of 8.3 years were studied. Thirty patients (33 per cent) had at least one re-resection, of whom 20 finally underwent total (procto)colectomy. Female sex and a history of perianal disease were identified as independent risk factors for re-resection: odds ratio 12.52 (95 per cent confidence interval (c.i.) 2.38 to 65.84) and 13.94 (95 per cent c.i. 3.02 to 64.27) respectively. Forty (44 per cent) of the 91 patients had a stoma at the end of the study period. Of the 30 patients who had re-resection, 24 finally had a stoma.


CONCLUSIONS
Segmental resection for Crohn's colitis is justified. Recurrence is more frequent in women and in those with a history of perianal disease.
Polle
S W
SW
Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
Slors
J F M
JF
Weverling
G J
GJ
Gouma
D J
DJ
Hommes
D W
DW
Bemelman
W A
WA
D000328:Adult; D003092:Colitis / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012044:Regression Analysis; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D054047:Surgical Stomas; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome