| International Session（Symposium）7(JSGS・JSGE・JGES) |
| Sat. November 23rd 10:00 - 12:00 Room 11: Kobe International Exhibition Hall No.2 Building Hall (North) |
| Risk factors for reoperation in Crohn’s disease: A Retrospective Multicenter Study in Japan | |||
| Keisuke Hata1, Takahide Shinagawa1, Soichiro Ishihara1 | |||
| 1Department of Surgical Oncology, The University of Tokyo | |||
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| Background & Aims: Patients with Crohn’s disease (CD) require multiple intestinal operations during their lifetime. We aimed to examine risk factors for reoperation in patients with CD who underwent intestinal surgery with particular focus on the postoperative treatment. Methods: A total of 2485 patients with CD who underwent initial intestinal surgery from 10 tertiary care institutions were retrospectively reviewed. The primary outcome was the need for a first reoperation. The reoperation rate was estimated using Kaplan-Meier methods, and risk factors for reoperation were investigated. Results: The overall cumulative 5- and 10-year reoperation rates were 24.4% and 48.4% respectively. Patients who underwent their initial operation after 2003 showed a significantly lower reoperation rate than before 2002 (5-yr cumulative reoperation rate 29.9% vs 18.9%, p<0.001). Those with postoperative use of anti-TNFα showed a lower reoperation rate (5-yr cumulative reoperation rate 17.7% vs 27.5%). Those with postoperative IM showed a lower reoperation rate (5-yr cumulative reoperation rate 13.6% vs 26.0%). In addition, those with combo therapy appeared to have lower risk of reoperation (5-year cumulative reoperation rate combo 13.1% vs. anti-TNFα alone19.3% vs. IM alone14.0%). Conclusions: The reoperation rate of CD significantly decreased after 2003. The absence of postoperative use of anti-TNFα and IM appeared to be risk factors for reoperation in CD. The postoperative combo therapy may be needed for high-risk patients for reoperation. |
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Index Term 1: Crohn Index Term 2: reoperation |
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