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Updated: Aug 7, 2025
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Complications and Disease Recurrence After Ileocecal Resection in Pediatric Crohn's Disease: A Retrospective Study
M Glenisson1, A Bonnard1, D Berrebi2
1Department of Pediatric Surgery, Hôpital Universitaire Robert Debré, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France.
Insights
Young age at diagnosis is a key predictor of postoperative recurrence (POR) in pediatric Crohn's disease (CD) following ileocecal resection. Early intervention and tailored therapies are crucial for managing this condition in young patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease affecting children.
- Ileocecal resection is a common surgical intervention for pediatric CD.
- Understanding postoperative recurrence (POR) and complications is vital for optimizing patient outcomes.
Purpose of the Study:
- To determine the risk of POR after ileocecal resection in pediatric CD patients.
- To assess the occurrence of surgical complications post-resection.
- To identify predictors of adverse postoperative outcomes in this population.
Main Methods:
- Retrospective study of pediatric CD patients (<18 years) undergoing primary ileocecal resection.
- Data collected between January 2006 and December 2016 from a tertiary center.
- Multivariate Cox regression analysis used to identify risk factors for POR.
Main Results:
- 35% of patients experienced POR by the end of a median 2.3-year follow-up.
- Young age at diagnosis was the only identified risk factor for POR.
- 16% of patients had severe postoperative complications, with intraoperative abscess being the sole risk factor.
Conclusions:
- Young age at diagnosis is a significant predictor of POR in pediatric CD.
- Targeted therapeutic strategies should be developed for young CD patients.
- Endoscopic dilatation may help delay or prevent surgical POR, avoiding further surgery.
Objective:
The aim of this retrospective study was to describe the risk of postoperative recurrence (POR) after ileocecal resection, the occurrence of surgical complications, and identify predictors of these adverse postoperative outcomes in pediatric Crohn's disease (CD).
Patients And Methods:
All the children less than 18 years of age with a diagnosis of CD, who underwent primary ileocecal resection for CD between January 2006 and December 2016 in our tertiary center, were considered for inclusion. Factors related to POR were investigated.
Results:
A total of 377 children were followed for CD between 2006 and 2016. During this period, 45 (12%) children needed an ileocecal resection. POR was diagnosed in 16% (n = 7) at 1 year and 35% (n = 15) at the end of the follow-up, with a median follow-up of 2.3 years (Q1-Q3 1.8-3.3). Median duration of the postoperative clinical remission was 1.5 years (range 0.5-2). Multivariate Cox regression analysis identified only young age at diagnosis as a risk factor for POR.In total, 7 of the 43 patients (16%) developed severe postoperative complications, defined as requiring surgical, endoscopic, or radiological intervention. The only risk factor was intraoperative abscess.
Conclusion:
Only young age at diagnosis was associated with POR. This information could be useful to develop targeted therapeutic strategies for young CD children. At the end of follow-up with a median follow-up of 2.3 years (Q1-Q3 1.8-3.3), there was no surgical POR: endoscopic dilatation for POR should be considered in order to delay or prevent surgery.
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