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Updated: Feb 16, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Long-Term Outcomes After Primary Bowel Resection in Pediatric-Onset Crohn's Disease
Firas Rinawi1, Noam Zevit1,2, Rami Eliakim2,3
1Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Insights
Pediatric-onset Crohn's disease (POCD) patients undergoing intestinal resection face significant long-term risks of flares and hospitalization. Extraintestinal manifestations (EIMs) are linked to increased hospitalization and repeat surgeries.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Inflammatory Bowel Disease Research
Background:
- Limited evidence exists on long-term outcomes after intestinal resection in pediatric-onset Crohn's disease (POCD).
- Predictors for adverse outcomes following surgery in POCD are not well-established.
Purpose of the Study:
- To investigate clinical outcomes in POCD patients after intestinal resection.
- To identify predictors of adverse outcomes following intestinal resection in POCD.
Main Methods:
- Retrospective review of medical records for POCD patients who had at least one intestinal resection (1990-2014).
- Key outcomes measured: time to first flare, hospitalization, second resection, and response to nonprophylactic biologic therapy.
- Statistical analysis included hazard ratios (HR) to assess risk factors.
Main Results:
- 121 POCD patients were included with a median follow-up of 6 years.
- High rates of postsurgical exacerbation (88%), hospitalization (43%), and second resection (14%) were observed.
- Extraintestinal manifestations (EIMs) correlated with shorter times to hospitalization (HR 2.7) and second resection (HR 3.1).
- Earlier surgery post-2000 was linked to shorter times to flare (HR 1.9) and hospitalization (HR 2.6).
Conclusions:
- POCD patients have significant long-term risks for flares, hospitalization, and biologic treatment post-bowel resection.
- EIMs are identified as a key risk factor for increased hospitalization and the need for subsequent intestinal resection.
Background:
There is limited evidence on the long-term outcome of intestinal resection in pediatric-onset Crohn's disease (POCD) with no established predictors of adverse outcomes. We aimed to investigate clinical outcomes and predictors for adverse outcome following intestinal resection in POCD.
Methods:
The medical records of patients with POCD who underwent at least 1 intestinal resection between 1990 and 2014 were reviewed retrospectively. Main outcome measures included time to first flare, hospitalization, second intestinal resection, and response to nonprophylactic biologic therapy.
Results:
Overall, 121 patients were included. Median follow-up was 6 years (range 1-23.6). One hundred and seven (88%) patients experienced at least 1 postsurgical exacerbation, 52 (43%) were hospitalized, and 17 (14%) underwent second intestinal resection. Of 91 patients who underwent surgery after the year 2000, 37 (41%) were treated with antitumor necrosis factor ɑ (anti-TNFɑ) (nonprophylactic) following intestinal resection. Time to hospitalization and to second intestinal resection were shorter among patients with extraintestinal manifestations (EIMs) (HR 2.7, P = 0.006 and HR = 3.1, P = 0.03, respectively). Time to initiation of biologic treatment was shorter in patients with granulomas (HR 2.1, P = 0.038), whereas being naïve to anti-TNFɑ treatment before surgery was a protective factor for biologic treatment following surgery (HR 0.3, P = 0.005). Undergoing intestinal resection beyond the year 2000 was associated with shorter time to first flare (HR 1.9, P = 0.019) and hospitalization (HR 2.6, P = 0.028).
Conclusion:
Long-term risk for flares, hospitalization, or biologic treatment is significant in POCD following bowel resection. EIMs increase the risk for hospitalization and second intestinal resection.
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