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Recurrence after segmental resection for colonic Crohn's disease
S W Polle1, J F M Slors, G J Weverling
1Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
The British Journal of Surgery
|July 22, 2005
Summary
Segmental colectomy for Crohn's disease is effective, but women and those with perianal disease face higher re-resection risks. Further surgery or stoma may be needed.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Inflammatory Bowel Disease Research
Background:
- Segmental colonic resection is a common surgical approach for colorectal Crohn's disease.
- Evaluating outcomes and identifying risk factors for re-resection after this procedure is crucial for patient management.
Purpose of the Study:
- To assess the long-term outcomes of segmental colonic resection in patients with Crohn's colitis.
- To identify patient, disease, and treatment-related factors predictive of re-resection.
Main Methods:
- A retrospective evaluation of consecutive patients undergoing initial segmental colonic resection for Crohn's colitis (1987-2000).
- Exclusion of patients who underwent ileocolonic resection.
- Analysis of variables to determine risk factors for disease recurrence and re-resection.
Main Results:
- Out of 91 patients, 33% required re-resection, with 20 undergoing total colectomy.
- Female sex (OR 12.52) and history of perianal disease (OR 13.94) were independent risk factors for re-resection.
- 44% of patients had a stoma at study end; 24 of 30 patients requiring re-resection ultimately had a stoma.
Conclusions:
- Segmental resection for Crohn's colitis is a justifiable treatment option.
- Women and patients with a history of perianal disease have a significantly higher risk of recurrence requiring re-resection.