Postoperative course of Crohn disease according to timing of bowel resection: Results from the CONNECT Study. Issue 16 (April 2018)

• Record Type: Journal Article
• Authors: Lee, Ji Min; Lee, Kang-Moon; Kim, Joo Sung; Kim, You Sun; Cheon, Jae Hee; Ye, Byong Duk; Kim, Young-Ho; Han, Dong Soo; Lee, Chang Kyun; Park, Hyun-Ju
• Other Names: Augustin. Goran section editor.
• Is Part Of: Medicine. Volume 97:Issue 16(2018)
• Publication Date: 2018-04
• Subjects: bowel resection -- clinical course -- Crohn disease -- early surgery; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000010459
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: Previous studies have demonstrated that early surgery in Crohn disease (CD) can result in a better clinical course than late surgery. The aim of this study was to compare the clinical course of CD following bowel resection performed at the time of diagnosis (early surgery) and during the course of the disease (late surgery). We reviewed medical records from a hospital-based cohort database that includes Korean CD patients diagnosed before 2009. Patients who underwent bowel resection were included. Age, sex, disease phenotype, time of surgery, medication history including use of corticosteroids, immunomodulators, and biologics, and further surgical history were assessed. In all, 243 CD patients who had undergone bowel resection were included, and 120 patients underwent surgery at the time of diagnosis, while 123 underwent surgery after diagnosis (median 105 months, range 2–277). The use of biologics was significantly higher in the late surgery group than in the early surgery group ( P = .020). The use of immunomodulators and reoperation rates did not differ between the groups. Early surgery was associated with less use of biologics (Kaplan–Meier curve analysis P = .015). Multivariate analysis indicated that early surgery and old age at surgery were independent variables associated with less use of biologics. CD patients who underwent bowel resection at the time of diagnosis have a more favorable disease course, represented by less use of biologics. Early surgery might be a treatment option in a subset of CD patients.