title: Surgical Treatment and Outcomes in Patients With Intestinal Behçet Disease: Long-term Experience of a Single Large-Volume Center.
abstract: BACKGROUND
  Few studies have examined the surgical treatment of intestinal Behçet disease. Consequently, there is currently no standard surgical treatment for intestinal Behçet disease. Instead, treatment is empirical and symptom based.
  
  
  OBJECTIVE
  Our aim was to evaluate the clinical course after surgery and determine the appropriate surgical options for intestinal Behçet disease.
  
  
  METHODS
  Medical charts of patients who underwent surgery for intestinal Behçet were retrospectively reviewed.
  
  
  METHODS
  The study was conducted at a tertiary referral center.
  
  
  METHODS
  Ninety-one patients who underwent surgical treatment for intestinal Behçet disease between January 1995 and December 2012 were included in this study.
  
  
  METHODS
  Primary outcomes measured were patient demographics, clinical characteristics, operative and postoperative outcomes, and long-term follow-up data.
  
  
  RESULTS
  Surgical treatment was mainly in response to intractability to medical treatment (56.0%), and 19.8% of patients underwent an emergency operation. Surgery was performed laparoscopically in 33.0% of the patients. Most patients received an ileocecectomy (39.6%) or a right hemicolectomy (34.1%). Twenty-eight patients (30.8%) experienced postoperative morbidities, and 8 patients (8.8%) required reoperations. There were 3 deaths. Reoperation was required for recurrent disease in 32 patients during the long-term follow-up, and the 5-year cumulative reoperation rate was 31.2% (95% CI, 20.4%-42.0%). Among those requiring a second operation, 53.1% were segmental colonic resections that included the previous anastomosis. From multivariable Cox regression analysis, independent predictors of surgical recurrence included postoperative use of steroids (HR = 2.85 (95% CI, 1.21-6.75); p = 0.02), postoperative complications (HR = 2.42 (95% CI, 1.12-5.22); p = 0.03), and BMI (HR per 1-kg/m increase in BMI = 0.90 (95% CI, 0.82-0.99); p = 0.04).
  
  
  CONCLUSIONS
  This study was designed retrospectively and had a small sample size.
  
  
  CONCLUSIONS
  Patients treated surgically for intestinal Behçet disease frequently have postoperative complications and the need for a stoma and have a high risk of recurrence.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Baek
authors.forename: Chang Woo
authors.initials: CW
authors.lastname: Kim
authors.forename: Min Soo
authors.initials: MS
authors.lastname: Cho
authors.forename: Hyun A
authors.initials: HA
authors.lastname: Jang
authors.forename: Seung Hyuk
authors.initials: SH
authors.lastname: Baik
authors.forename: Hyuk
authors.initials: H
authors.lastname: Hur
authors.forename: Byung Soh
authors.initials: BS
authors.lastname: Min
authors.forename: Nam Kyu
authors.initials: NK
authors.lastname: Kim
mesh_terms: D000328:Adult; D001528:Behcet Syndrome / Q000601:surgery*; D003082:Colectomy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery; D008297:Male; D012008:Recurrence; D012044:Regression Analysis; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome