[Azathioprine for prevention of postoperative recurrence in Crohn's disease].
BACKGROUND
Crohn's disease is a chronic inflammatory bowel disease that can involve any portion of the gastrointestinal tract. Up to 74% of patients require surgery. However, although resective surgery improves the clinical situation, relapses is frequent in most cases. THE AIM of this clinical trial was to evaluate the profile of patient who received AZA after surgical treatment in order to prevent postoperative recurrence.


METHODS
This was a retrospective study including 17 patients with severe Crohn's disease attending our gastrointestinal unit from September 1998 to June 2004. Patients were eligible if they have severe Crohn's disease, undergoing curative surgical treatment and received azathioprine for the first time after surgery to prevent postoperative recurrence.


RESULTS
The study population comprised 17 patients with Crohn's disease (10 men and 7 women; mean age, 27 years). The Crohn's disease was ileo-colic in 10 cases with perineal manifestations for 2 patients and ileal in 7 cases. The indications for surgery were stenosis in 10 cases, fistula in 5 cases, perforation in 1 case and corticosteroid-resistance in 1 case. The median following-up period was 40 months (9-80 months). During this period, only 1 patient reported severe adverse event and discontinued treatment due to acute pancreatitis. 1 patient was lost to follow-up and 3 patients had moderate clinical relapse. Maintained remission was obtained for 12 patients. None of our patients had surgical relapse.


CONCLUSIONS
The result of this study shows the effect of Azathioprine in preventing both clinical and surgical relapses in patients with Crohn's disease who have undergone surgery.
Service de Gastroentérologie, Hôpital Militaire de Tunis, Tunisie.
M Nabil
MN
Abdelli
H
H
Ben Abdallah
F
F
Houissa
M Riadh
MR
Bouali
M Faouzi
MF
Khediri
D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use*; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies; D055502:Secondary Prevention
D007166:Immunosuppressive Agents; D001379:Azathioprine