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Risk Factors for Postoperative Recurrence in Korean Patients with Crohn's Disease scie scopus kci등재

  • 주제(키워드) Crohn disease , Recurrence , Surgery , Risk factors , Thiopurine
  • 주제(기타) Gastroenterology & Hepatology
  • 설명문(일반) [Kim, Sung; Cheon, Jae Hee; Park, Jae Jun] Yonsei Univ, Inst Gastroenterol, Dept Internal Med, Coll Med, Seoul, South Korea; [Kim, Eun Soo; Jeon, Seong Woo] Kyungpook Natl Univ, Sch Med, Dept Internal Med, Daegu, South Korea; [Jung, Sung-Ae] Ewha Womans Univ, Dept Internal Med, Sch Med, Seoul, South Korea; [Park, Dong Il] Sungkyunkwan Univ, Dept Internal Med, Kangbuk Samsung Hosp, Sch Med, Seoul, South Korea; [Lee, Chang Kyun] Kyung Hee Univ, Ctr Crohns & Colitis, Dept Gastroenterol, Coll Med, Seoul, South Korea; [Im, Jong Pil] Seoul Natl Univ, Dept Internal Med, Coll Med, Seoul, South Korea; [Im, Jong Pil] Seoul Natl Univ, Liver Res Inst, Coll Med, Seoul, South Korea; [Kim, You Sun] Inje Univ, Dept Internal Med, Coll Med, Seoul Paik Hosp, Seoul, South Korea; [Kim, Hyun Soo] Chonnam Natl Univ, Dept Internal Med, Div Gastroenterol, Med Sch, Gwangju, South Korea; [Lee, Jun] Chosun Univ, Dept Internal Med, Coll Med, Gwangju, South Korea; [Eun, Chang Soo] Hanyang Univ, Dept Internal Med, Guri Hosp, Guri, South Korea; [Lee, Jeong Mi] Wonkwang Univ, Dept Publ Hlth, Grad Sch, Iksan, South Korea; [Jang, Byung Ik] Yeungnam Univ, Dept Internal Med, Coll Med, Daegu, South Korea; [Seo, Geom Seog] Wonkwang Univ, Digest Dis Res Inst, Dept Internal Med, Coll Med, 460 Iksan Daero, Iksan 54538, South Korea
  • 등재 SCIE, SCOPUS, KCI등재
  • OA유형 Green Published, gold
  • 발행기관 EDITORIAL OFFICE GUT & LIVER
  • 발행년도 2020
  • 총서유형 Journal
  • URI http://www.dcollection.net/handler/ewha/000000169185
  • 본문언어 영어
  • Published As https://dx.doi.org/10.5009/gnl19085
  • PubMed https://pubmed.ncbi.nlm.nih.gov/31550869

초록/요약

Background/Aims: A considerable number of patients with Crohn's disease still need intestinal resection surgery. Postoperative recurrence is an important issue in Crohn's disease management, including the selection of high-risk patients. Eastern Asian patients showed several differences from Caucasian patients. Therefore, we investigated the postoperative surgical recurrence outcome and identified risk factors in Korean patients. Methods: Clinical data of 372 patients with Crohn's disease who underwent first intestinal resection between January 2004 and August 2014 at 14 hospitals in Korea were retrospectively reviewed. Results: Over the follow-up period, 50 patients (17.1%) showed surgical recurrence. The cumulative surgical recurrence rate was 6.5% at 1 year and 15.4% at 7 years. Age under 16 (p=0.011; hazard ratio [HR], 5.136; 95% confidence interval [CI], 1576 to 16.731), colonic involvement (p=0.023; HR , 2.011; 95% CI, 1.102 to 3.670), and the presence of perianal disease at surgery (p=0.008; HR, 2.239; 95% CI, 1.236 to 4.059) were independent risk factors associated with surgical recurrence. Postoperative thiopurine treatment (p=0.002; HR, 0.393; 95% CI, 0.218 to 0.710) was a protective factor for surgical recurrence. Conclusions: Among the disease characteristics at surgery, younger age, colonic location, and perianal lesions were independent risk factors for surgical recurrence. Postoperative thiopurine treatment significantly reduced the incidence of surgical recurrence.

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