title: Factors influencing disease recurrence after ileocolic resection in adult and pediatric onset Crohn's disease.
abstract: BACKGROUND
  Factors influencing recurrence of ileocecal Crohn's disease (CD) after surgical resection may differ between adolescents and adults.
  
  
  METHODS
  CD patients who underwent ileocecectomy were retrospectively divided into pediatric onset (age at diagnosis ≤ 16 years, n = 34) and adult onset (>16, n = 108) patients to evaluate differences in risks of endoscopic and clinical recurrence.
  
  
  RESULTS
  In 142 patients, rates of any recurrence, endoscopic recurrence, and clinical recurrence at 5 years were 78%, 88%, and 65%, respectively. Risks of recurrence were similar between groups. Younger patients were more likely to be on immunologics preoperatively and more likely to be started on immunoprophylaxis postoperatively. Immediate postoperative prophylaxis was predictive of delayed clinical recurrence only in the older group.
  
  
  CONCLUSIONS
  Despite increased preoperative and postoperative immunoprophylaxis in younger patients, recurrence rates of CD after ileocecectomy do not differ between these groups. Immediate postoperative prophylaxis was predictive of delayed clinical recurrence only in patients with adult onset CD.
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Case Western/University Hospital Case Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH 44106, USA. Electronic address: iuliana.bobanga@uhhospitals.org.
authors.forename: Iuliana D
authors.initials: ID
authors.lastname: Bobanga
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Case Western/University Hospital Case Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH 44106, USA.
authors.forename: Shiyu
authors.initials: S
authors.lastname: Bai
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Case Western/University Hospital Case Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH 44106, USA.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Swanson
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Case Western/University Hospital Case Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH 44106, USA.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Champagne
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Case Western/University Hospital Case Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH 44106, USA.
authors.forename: Harry J
authors.initials: HJ
authors.lastname: Reynolds
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Case Western/University Hospital Case Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH 44106, USA.
authors.forename: Conor P
authors.initials: CP
authors.lastname: Delaney
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Case Western/University Hospital Case Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH 44106, USA.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Barksdale
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Case Western/University Hospital Case Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH 44106, USA.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003082:Colectomy / Q000379:methods*; D003092:Colitis / Q000453:epidemiology / Q000601:surgery*; D003106:Colon / Q000601:surgery*; D003424:Crohn Disease / Q000453:epidemiology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007079:Ileitis / Q000453:epidemiology / Q000601:surgery*; D007082:Ileum / Q000601:surgery*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Crohn's disease; Ileocecectomy; Immunoprophylaxis; Pediatric; Recurrence