title: [Crohn's disease surgery: problems of postoperative recurrence].
abstract: Crohn's disease is associated with high rates of postoperative recurrence. By 10 years postoperatively a high percentage of patients suffer clinical relapses (as many as 75% and above) and many of these (up to 45%) require re-intervention. The aim of the study was to identify, among the various potentially predictive factors, those which today can be considered real risk factors for postoperative recurrence. A review of the literature of the last two decades was carried out. Factors related to the patient, disease, type of surgery and pharmacological treatment were analysed. The relapse rate we recorded was 41.17% (28 of 62 patients operated on in the last 20 years and included in an average 6-year follow-up (range: 1-19 years). Significant predictive factors, in adition to duration of the follow-up and smoking, are also the location of the disease in the colon, extent more than 100 cm and the absence of postoperative pharmacological prophylaxis. The high incidence of postoperative recurrence in Crohn's disease mandates a strict follow-up (clinical, laboratory and instrumental monitoring). Identifying patients at increased risk would enable physicians to implement a rational pharmacological prophylaxis.
authors.affiliation: Patologia Chirurgica a Indirizzo Gastroenterologico, Dipartimento di Discipline Chirurgiche e Metodologie Integrate, Università degli Studi di Genova.
authors.forename: Rosario
authors.initials: R
authors.lastname: Fornaro
authors.forename: Marco
authors.initials: M
authors.lastname: Frascio
authors.forename: Cesare
authors.initials: C
authors.lastname: Stabilini
authors.forename: Camilla
authors.initials: C
authors.lastname: Sticchi
authors.forename: Andrea
authors.initials: A
authors.lastname: Barberis
authors.forename: Andrea
authors.initials: A
authors.lastname: Denegri
authors.forename: Barbara
authors.initials: B
authors.lastname: Ricci
authors.forename: Antonio
authors.initials: A
authors.lastname: Azzinnaro
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Lazzara
authors.forename: Ezio
authors.initials: E
authors.lastname: Gianetta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000069285:Infliximab; D010535:Laparoscopy; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage / Q000627:therapeutic use; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011182:Postoperative Care; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents; D008795:Metronidazole; D019804:Mesalamine; D000069285:Infliximab