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P116. The influence of appendectomy on the clinical course of ulcerative colitis: a hospital-based cohort study from Korea

J.-S. Byeon, S.H. Park, J.S. Soh, S.-K. Yang, S.-J. Myung, K.-J. Kim, B.D. Ye, K.W. Jung, D.-H. Yang, J.-H. Kim, H.-S. Lee, H.J. Lee, J.-B. Kim, S.-K. Park, University of Ulsan College of Medicine, Asan Medical Center, Gastroenterology, Seoul, South Korea

Background

There has been limited data regarding the effect of appendectomy on the clinical course of ulcerative colitis (UC). Also, the results of previous studies were controversial. The aim of this study was to compare the clinical course of UC in appendectomized patients and non-appendectomized patients in Korea.

Methods

We used the Asan Inflammatory Bowel Disease registry to get data of patients diagnosed with UC until 2012. Patients were classified as appendectomized if appendectomy had been performed before UC diagnosis. If patients had undergone appendectomy after UC diagnosis, they were classified as non-appendectomized and the last follow-up of these patients was defined as the date of appendectomy to exclude the effect of appendectomy on the course of UC after appendectomy. The clinical courses of UC in appendectomized and non-appendectomized patients were evaluated in regard to the use of medication and colectomy.

Results

A total of 2,497 patients with UC were seen at the Asan Medical Center during the study period. Among them, 151 patients were excluded because the appendectomy status was unknown. The remaining 2,346 UC patients were studied. Of the study patients, 66 (2.8%) had undergone appendectomy before UC diagnosis and 35 (1.5%) had undergone appendectomy after UC diagnosis. During the follow-up, 10.6% of patients underwent colectomy in appendectomized patients (7/66) and 8.6% of patients underwent colectomy in non-appendectomized patients (195/2,280) (p = 0.56). The 10 and 20 year probabilities of colectomy were 13.7% and 19.9% in appendectomized patients compared with 9.1% and 16.5% in non-appendectomized patients (p = 0.62). Two patients (3.0%) received anti-tumor necrosis factor (anti-TNF) agents in appendectomized patients and 117 patients (5.1%) received anti-TNF agents in non-appendectomized patients during the follow-up period (p = 0.44). The cumulative probabilities of starting anti-TNF agents were not significantly different between appendectomized and non-appendectomized patients (5.0% vs. 6.1% at 10 years and 5.0% vs. 10.4% at 20 years, p = 0.44). Also, the cumulative probabilities of starting corticosteroids and azathioprine/6-mercaptopurine were not significantly different between the two groups (corticosteroids, p = 0.85, azathioprine/6-mercaptopurine, p = 0.71).

Conclusion

These results indicated that appendectomy had no significant beneficial effect on the clinical course of UC in regard to medication use and colectomy in the Korean population.

This study was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A120176).