[Factors of recurrence in Crohn disease]

The surgical treatment of complications of Crohn's disease is often postponed, because of the threat of short gut and high recurrence rates. We reviewed retrospectively 286 cases of intestinal resection to evaluate factors influencing the recurrence of Crohn's disease after surgery. Recurrence was defined as the need for reoperation. Risk factors used as independent variables are all subject of controversy in recent literature. These factors included: smoking, blood transfusion, contamination, localisation of the disease, length of resection, microscopic margins and the duration of follow-up. A logistic regression model was calculated, using recurrence as the dependent variable. The mean follow-up is 55 months. Kaplan Meier was used to measure the recurrence rate. Duration of follow-up is the most important variable. The length of resection and the positive margins can statistically predict recurrence (p = 0.046 et p = 0.016), both having a predictive value of 72%. A resection with clear margins decreases the recurrence rate significantly (15%) (p = 0.0025).