title: Surgical recurrence after primary ileocolic resection for Crohn's disease.
abstract: BACKGROUND
  The current study was conducted to assess long-term outcomes after primary ileocolic resection for Crohn's disease (CD) and to identify factors associated with surgical relapse in the era of immunosuppressive medications.
  
  
  METHODS
  Data were collected retrospectively on 116 consecutive patients, who underwent primary ileocolic resection for CD at a tertiary referral center between 1997 and 2006. Medical records were reviewed, and the use of immunomodulators was noted. The cumulative probability for a second operation due to recurrent CD was described by Kaplan-Meier curves.
  
  
  RESULTS
  Ten patients (8.6 %) developed surgical recurrence after a mean follow-up period of 8.1 (±2.6) years. The percentage of patients not requiring further surgery was 96.5% and 88.0 % at 5 and 10 years, respectively. An urgent indication for surgery was significantly associated with the necessity of repeated intestinal resection (hazard ratio 5.6, 95 % confidence interval 1.2-27.0, p = 0.0145). In addition, postoperative exposure to azathioprine/6-mercaptopurine for more than 3 months decreased the probability of surgical recurrence significantly (hazard ratio 2.5, 95 % confidence interval 0.6-9.9, p = 0.0349).
  
  
  CONCLUSIONS
  In contrast to previous studies, we observed a significant low surgical recurrence rate after primary ileocolic resection. Additionally, maintenance treatment with azathioprine/6-mercaptopurine after surgery may reduce the necessity for repeat surgical intervention.
authors: Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria, stefan.riss@meduniwien.ac.at.
authors: S
authors: S
authors: Riss
authors: I
authors: I
authors: Schuster
authors: P
authors: P
authors: Papay
authors: F
authors: F
authors: Herbst
authors: M
authors: M
authors: Mittlböck
authors: P
authors: P
authors: Chitsabesan
authors: A
authors: A
authors: Stift
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000601:surgery*; D003424:Crohn Disease / Q000188:drug therapy / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents
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