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International Journal of Colorectal Disease

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01-10-2017 | Original Article

Risk factors associated with postoperative recurrence and repeat surgery in Japanese patients with Crohn’s disease

Authors: Jun Kusaka, Hisashi Shiga, Masatake Kuroha, Tomoya Kimura, Yoichi Kakuta, Katsuya Endo, Yoshitaka Kinouchi, Tooru Shimosegawa

Published in: International Journal of Colorectal Disease | Issue 10/2017

Abstract

Purpose

To avoid frequent surgery in patients with Crohn’s disease, it is important to identify the risk factors for postoperative recurrence or repeat surgery. However, there have so far been few studies on this topic from Asian countries. In addition, the recent development of anti-tumor necrosis factor (TNF) therapy may have changed the risk factors. We aimed to identify the factors associated with postoperative recurrence and repeat surgery.

Methods

The postoperative courses of 168 patients were reviewed. We analyzed the cumulative postoperative recurrence and repeat surgery rates and identified the factors affecting these rates.

Results

Postoperative recurrence was observed in 70 patients, and the 1-, 3-, and 5-year cumulative recurrence rates were 17.1, 40.1, and 54.9%, respectively. The recurrence rate was significantly higher in patients with anal lesions and lower in patients newly treated with anti-TNF agents following surgery. In a multivariate analysis, the new introduction of anti-TNF agents was identified as an independent suppressor (hazard ratio 0.50, 95% confidence interval 0.28–0.88). Twenty-four patients underwent repeat surgery, and the 1-, 3-, and 5-year cumulative repeat surgery rates were 4.6, 11.2, and 18.7%, respectively. The surgery rate was significantly higher in patients with penetrating-type disease. In a multivariate analysis, penetrating-type disease (6.98, 2.37–23.35), anal lesions (4.40, 1.14–30.53), and first-time surgery (5.28, 1.17–17.93) were identified as independent risk factors.

Conclusions

Anti-TNF agents have the potential to prevent postoperative recurrence. The new introduction, dose escalation, or switching of anti-TNF agents is recommended in patients with some risk factors.

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Title: Risk factors associated with postoperative recurrence and repeat surgery in Japanese patients with Crohn’s disease
Authors: Jun Kusaka
Hisashi Shiga
Masatake Kuroha
Tomoya Kimura
Yoichi Kakuta
Katsuya Endo
Yoshitaka Kinouchi
Tooru Shimosegawa
Publication date: 01-10-2017
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 10/2017
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-017-2867-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk factors associated with postoperative recurrence and repeat surgery in Japanese patients with Crohn’s disease

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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