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Updated: Apr 21, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Surgery and postoperative recurrence in children with Crohn disease
Lars F Hansen1, Christian Jakobsen, Anders Paerregaard
1*Department of Paediatrics, Hvidovre University Hospital, Hvidovre †Department of Paediatrics and Gastrointestinal Surgery, Odense University Hospital, Odense, Denmark.
Insights
Pediatric Crohn disease (CD) surgery often leads to high recurrence rates, with 77% of children experiencing disease recurrence within 10 years. Many patients require multiple intestinal resections.
Area of Science:
- Pediatric Gastroenterology
- Surgical Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Crohn disease (CD) is a chronic inflammatory bowel disease affecting children.
- Surgical intervention is sometimes necessary for pediatric CD management.
- Understanding long-term outcomes after surgery is crucial for patient care.
Purpose of the Study:
- To determine surgery rates, complications, and disease recurrence risks in pediatric Crohn disease.
- To analyze factors influencing outcomes following intestinal resection in children with CD.
- To provide long-term follow-up data on surgical management of pediatric CD.
Main Methods:
- Retrospective cohort study of children (<18 years) diagnosed with CD and undergoing intestinal resection.
- Data extracted from the Danish National Patient Registry (1978-2007) and patient charts.
- Analysis included Montreal classification, surgical procedures, medication use, and recurrence rates over a median follow-up of 121 months.
Main Results:
- 115 pediatric CD patients underwent intestinal resection; 39% required more than one surgery.
- Cumulative clinical recurrence rates at 1, 5, and 10 years were 50%, 73%, and 77%, respectively.
- Postoperative azathioprine treatment did not significantly impact recurrence rates.
Conclusions:
- Pediatric Crohn disease surgery is associated with a high rate of disease recurrence.
- A significant proportion of children with CD require multiple intestinal resections.
- Long-term monitoring and management strategies are essential after surgery for pediatric CD.
Objectives:
The aim of this study was to describe surgery rates, complications, and risk of disease recurrence after surgery in paediatric Crohn disease (CD).
Methods:
Children <18 years with a diagnosis of CD and a least 1 intestinal resection from the period January 1, 1978 to December 31, 2007 were identified using the Danish National Patient Registry. Patient charts were used to extract data.
Results:
A total of 115 of 422 children with CD, who had surgery in 2 referral centres, were further studied. Disease extension according to the Montreal classification at the time of operation was available in 106/115 patients: B1, 39/106 (37%); B2, 59/106 (56%); and B3, 8/106 (7%). Before/after surgery 89%/36% of the patients received corticosteroids, 26%/61% azathioprine, and 15%/34% infliximab. Ileocoecal resection was performed in 54 (47%); 17 (15%) underwent ileal resection, 21 (18%) colectomy, 13 (11%) hemicolectomy, and 10 (9%) a combined colonic and ileal resection. Median time from diagnosis to surgery was 23 months (range 0-147). The median follow-up time after surgery was 121 months (16-226), and median time to disease recurrence was 12 months (3-160). The cumulative clinical recurrence rates at 1, 5, and 10 years were 50%, 73%, and 77%, respectively. More than 1 bowel resection was needed in 39%. Postoperative azathioprine treatment did not affect rate of recurrence after surgery.
Conclusions:
In this large cohort of children with CD studied for >10 years postoperatively, we found a high postoperative recurrence rate of disease and a frequent need for >1 intestinal resection.
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