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Updated: Mar 8, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Complications and Disease Recurrence After Primary Ileocecal Resection in Pediatric Crohn's Disease: A Multicenter
Kay Diederen1, Lissy de Ridder, Patrick van Rheenen
1*Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands; †Department of Pediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands; ‡Department of Pediatric Gastroenterology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands; §Department of Pediatric Gastroenterology, University Medical Center Utrecht, Utrecht, the Netherlands; ‖Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands; ¶Department of Pediatric Gastroenterology, Radboud University Medical Center, Nijmegen, the Netherlands; **Department of Pediatric Gastroenterology, VU University Medical Center, Amsterdam, the Netherlands; ††Department of Pediatrics, Amphia Hospital, Breda, the Netherlands; ‡‡Department of Pediatric Surgery, Academic Medical Center, Amsterdam, the Netherlands; and §§Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
Insights
Ileocecal resection for pediatric Crohn's disease is effective but has frequent complications. Immediate postoperative therapy can reduce disease recurrence, highlighting its importance in managing pediatric Crohn's disease outcomes.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Inflammatory Bowel Disease Research
Background:
- Limited follow-up in pediatric Crohn's disease (CD) ileocecal resection studies.
- Need to identify predictors of adverse outcomes post-surgery.
- Investigating complication and recurrence rates after ileocecal resection in pediatric CD.
Purpose of the Study:
- To determine complication rates following ileocecal resection in pediatric CD.
- To identify risk factors for severe complications and disease recurrence.
- To evaluate the impact of immediate postoperative therapy on recurrence.
Main Methods:
- Retrospective cohort analysis of pediatric CD patients (<18 years).
- Inclusion of patients undergoing ileocecal resection as first intestinal resection.
- Multivariable analysis to identify risk factors for adverse outcomes.
Main Results:
- 10% rate of severe postoperative complications.
- Risk factors for complications include colonic disease, positive resection margins, and emergency surgery.
- 1, 5, and 10-year recurrence rates: 19%, 49%, 71% (clinical) and 2%, 12%, 22% (surgical).
- Female sex, ileocecal disease, and positive resection margins are risk factors for recurrence.
- Immediate postoperative therapy significantly reduced both clinical and surgical recurrence.
Conclusions:
- Ileocecal resection is an effective and durable treatment for pediatric CD.
- Postoperative complications are frequent, necessitating careful management.
- Immediate postoperative therapy is crucial for preventing disease recurrence.
Background:
Studies on the outcome of ileocecal resection in pediatric Crohn's disease (CD) have a limited follow-up and fail to assign predictors of adverse outcomes. Therefore, we aimed to investigate (I) the complication and disease recurrence rates and (II) identify risk factors for these adverse outcomes after ileocecal resection for pediatric CD.
Methods:
This is a retrospective cohort analysis of all children (<18 years) that underwent ileocecal resection as first intestinal resection for CD derived from 7 tertiary hospitals in the Netherlands (1990-2015). Risk factors were identified using multivariable analysis.
Results:
In total, 122 children were included (52% male; median age 15.5 years [interquartile range 14.0-16.0]). Severe postoperative complications rate was 10%. Colonic disease (odds ratio: 5.6 [95% confidence interval {CI}: 1.3-26.3], P = 0.024), microscopically positive resection margins (odds ratio: 10.4 [95% CI: 1.1-100.8] P = 0.043), and emergency surgery (odds ratio: 6.8 [95% CI: 1.1-42.2], P = 0.038) were risk factors for severe complications. Clinical and surgical recurrence rates after 1, 5 and 10 years were 19%, 49%, 71% and 2%, 12%, 22%, respectively. Female sex (hazard ratio [HR]: 2.1 [95% CI: 1.1-3.8], P = 0.023) was a risk factor for clinical recurrence, whereas ileocecal disease (HR: 3.9 [95% CI: 1.2-12.5], P = 0.024) and microscopically positive resection margins (HR: 9.6 [95% CI: 1.2-74.5], P = 0.031) were risk factors for surgical recurrence. Immediate postoperative therapy reduced the risk of both clinical (HR: 0.3 [95% CI: 0.1-0.6], P = 0.001) and surgical (HR: 0.5 [95% CI: 0.1-0.9], P = 0.035) recurrence.
Conclusions:
Ileocecal resection is an effective and durable treatment of pediatric CD, although postoperative complications occur frequently. Postoperative therapy may be started immediately to prevent disease recurrence.
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