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Updated: May 22, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Long-term outcome after first intestinal resection in pediatric-onset Crohn's disease: a population-based study
Médina Boualit1, Julia Salleron, Dominique Turck
1Univ Lille Nord de France, CHU Lille and Lille-2 University, Gastroenterology Unit, France.
Insights
Early surgery in pediatric Crohn's disease (CD) improves outcomes. Performing the first surgery within 3 years of CD diagnosis reduces the need for immunosuppressors and biologics, promoting better nutritional catch-up.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Surgical Outcomes in Children
Background:
- Crohn's disease (CD) in children presents unique challenges for long-term management.
- Understanding postoperative evolution is crucial for optimizing treatment strategies in pediatric CD.
- A significant subset of pediatric CD patients require surgical intervention.
Purpose of the Study:
- To describe the long-term postoperative course of pediatric-onset Crohn's disease.
- To identify predictors of clinical outcomes following surgery in pediatric CD patients.
- To evaluate the impact of surgical timing on nutritional recovery.
Main Methods:
- Population-based cohort study of 404 pediatric-onset CD patients (1988-2004), with 130 undergoing surgery.
- Survival analysis and Cox models to estimate risks for re-operation and need for immunosuppressors (IS) or biologics.
- Regression analysis to assess the impact of early surgery on nutritional catch-up.
Main Results:
- A second resection probability of 29% at 10 years post-surgery.
- Factors predicting re-operation included younger age at diagnosis (<14 years), stenosing (B2), penetrating (B3) disease behavior, and upper GI location (L4).
- Early surgery (within 3 years of diagnosis) was associated with a reduced need for IS/biologics and improved height and weight catch-up.
Conclusions:
- In pediatric Crohn's disease, surgery within 3 years of diagnosis is linked to better long-term outcomes.
- Early surgical intervention may mitigate the need for escalated medical therapy (IS/biologics).
- Timely surgery positively influences nutritional rehabilitation in pediatric CD patients.
Background:
To describe long-term postoperative evolution of pediatric-onset Crohn's disease (CD) and identify predictors of outcome we studied a population-based cohort (1988-2004) of 404 patients (0-17 years), of which 130 underwent surgery.
Methods:
Risks for a second resection and first need for immunosuppressors (IS) and/or biologics were estimated by survival analysis and Cox models used to determine predictors of outcome. Impact of time of first surgery on nutritional catch-up was studied using regression.
Results:
In all, 130 patients (70 females) with a median age at diagnosis of 14.2 years (interquartile range: 12-16) were followed for 13 years (9.4-16.6). Probability of a second resection was 8%, 17%, and 29% at 2, 5, and 10 years, respectively. In multivariate analysis, age <14, stenosing (B2) and penetrating (B3) behaviors and upper gastrointestinal location (L4) at diagnosis were associated with an increased risk of second resection. Probability of receiving IS or biologics was 18%, 34%, and 47% at 2, 5, and 10 years, respectively. In multivariate analysis, L4 was a risk factor for requiring IS or biologics, while surgery within 3 years after CD diagnosis was protective. Catch-up in height and weight was better in patients who underwent surgery within 3 years after CD diagnosis than those operated on later.
Conclusions:
In this pediatric-onset CD study, mostly performed in a prebiologic era, a first surgery performed within 3 years after CD diagnosis was associated with a reduced need for IS and biologics and a better catch-up in height and weight compared to later surgery.
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