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Risk Factors for Repeat Abdominal Surgery in Korean Patients with Crohn’s Disease: A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group

대한대장항문학회지 2012년 28권 4호 p.188 ~ 194
 ( Lee Kil-Yeon ) - Kyung Hee University School of Medicine Department of Surgery

 ( Yu Chang-Sik ) - University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
 ( Lee Kang-Young ) - Yonsei University College of Medicine Department of Surgery
 ( Cho Yong-Beom ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
 ( Park Kyu-Joo ) - Seoul National University College of Medicine Department of Surgery
 ( Choi Gyu-Seog ) - Kyungpook National University School of Medicine Department of Surgery
 ( Yoon Sang-Nam ) - Hansol Hospital Department of Surgery
유한나 ( Yoo Han-Na ) - Korea University College of Political Science and Economics Department of Statistics

Abstract


Purpose: The purpose of this study was to assess the risk factors for repeated abdominal surgery in Crohn’s disease (CD) patients after the first abdominal surgery. Prior studies have tried to identify the risk factors for postoperative recurrence in CD patients, but the results of the studies have been inconsistent. Furthermore, few data on the risk factors for repeated abdominal surgery are available.

Methods: Clinical data on CD patients who underwent abdominal surgery from January 2000 to December 2009 were collected from seventeen university hospitals and one colorectal clinic. Data from a total of 708 patients were analyzed to find the risk factors for repeated abdominal surgery in CD patients. The mean follow-up period was 72 months.

Results: The risk of repeated abdominal surgery was 3 times higher in young patients (below 16 years old) than in older patients (odds ratio [OR], 3.056; 95% confidence interval [CI], 1.021 to 9.150); P = 0.046). Stricturing behavior at diagnosis was also a risk factor for repeated abdominal surgery (OR, 2.438; 95% CI, 1.144 to 5.196; P = 0.021). Among operative indications, only intra-abdominal abscess was associated with repeated abdominal surgery (OR, 2.393; 95% CI, 1.098 to 5.216; P = 0.028). Concerning type of operation, an ileostomy might be a risk factor for repeated abdominal surgery (OR, 11.437; 95% CI, 1.451 to 90.124; P = 0.021). Emergency surgery (OR, 4.994; 95% CI, 2.123 to 11.745; P < 0.001) and delayed diagnosis after surgery (OR, 2.339; 95% CI, 1.147 to 4.771; P = 0.019) also increased the risk of repeated abdominal surgery.

Conclusion: Young age (below 16 years), stricturing behavior, intra-abdominal abscess, emergency surgery, and delayed diagnosis after surgery were identified as possible risk factors for repeated abdominal surgery in CD patients.

키워드

Crohn’s disease; Recurrence; Surgery
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