Interval of less than 5 years between the first and second operation is a risk factor for a third operation for Crohn's disease

✍ Scribed by Toshiaki Watanabe; Iwao Sasaki; Akira Sugita; Kohei Fukushima; Kitaro Futami; Toshifumi Hibi; Mamoru Watanabe

• Publisher: John Wiley and Sons
• Year: 2012
• Tongue: English
• Weight: 614 KB
• Volume: 18
• Category: Article
• ISSN: 1078-0998
• DOI: 10.1002/ibd.21671

✦ Synopsis

Background: Previous studies have shown various risk factors for the initial and/or the second operation for Crohn's disease (CD). However, limited data are available with regard to the risk factors for a third operation. We aimed to clarify the risk factors for a third operation for CD.

Methods: A total of 200 CD patients who underwent a second intestinal surgery at 13 institutions were examined. We performed univariate and multivariate analyses to examine the influence of independent variables on the cumulative rate of needing a third operation.

Results: A total of 95 patients underwent a third operation. The overall 5-year and 10-year cumulative rates for the third operation were 42.2% and 71.0%, respectively. In univariate analysis, the interval between the initial and the second operation (P ¼ 0.0069), postoperative administration of infliximab (P ¼ 0.0030), and the anatomical site of the disease (P ¼ 0.0132) were significant risk factors for the third operation. In multivariate analysis, the interval between the initial and the second operation (P ¼ 0.0287) and postoperative administration of infliximab (P ¼ 0.0297) remained significant risk factors for the third operation. The cumulative 5-year third operation rate was significantly higher in patients with an interval of less than 5 years between the first and second operations than for those with an interval of 5 years or more (47.8% versus 35.2%, P ¼ 0.0232).

Conclusions: An interval of less than 5 years between the first and the second operations is a significant risk factor for a third operation in patients with CD.