This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Short‐ and medium‐term outcomes following primary ileocaecal resection for Crohn’s disease in two specialist centres. BJS 2017; 104: 1713-1722.
Published: 26th July 2017
Authors: A. de Buck van Overstraeten, E. J. Eshuis, S. Vermeire, G. Van Assche, M. Ferrante, G. R. D'Haens et al.
Background
Despite improvements in medical therapy, the majority of patients with Crohn's disease still require surgery. The aim of this study was to report safety, and clinical and surgical recurrence rates, including predictors of recurrence, after ileocaecal resection for Crohn's disease.
Method
This was a cohort analysis of consecutive patients undergoing a first ileocaecal resection for Crohn's disease between 1998 and 2013 at one of two specialist centres. Anastomotic leak rate and associated risk factors were assessed. Kaplan–Meier estimates were used to describe long‐term clinical and surgical recurrence. Univariable and multivariable regression analyses were performed to identify risk factors for both endpoints.
Results
In total, 538 patients underwent primary ileocaecal resection (40·0 per cent male; median age at surgery 31 (i.q.r. 24–42) years). Median follow‐up was 6 (2–9) years. Fifteen of 507 patients (3·0 per cent) developed an anastomotic leak. An
Conclusion
Ileocaecal resection achieved durable medium‐term remission, but smoking and resection margin positivity were risk factors for recurrence.
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