P538. Clinical and endoscopic recurrence after surgical resection in patients with Crohn's disease
Y.W. Lee1, K.-M. Lee1, W.C. Chung1, C.N. Paik1, H.J. Sung1, Y.S. Oh1, S.H. Jung2, 1St. Vincent's Hospital, The Catholic University of Korea, Internal Medicine, Suwon, South Korea, 2St. Paul's Hospital, The Catholic University of Korea, Internal Medicine, Seoul, South Korea
The natural history of Crohn's disease (CD) is characterized by the remitting and relapsing course and considerable patients ultimately require bowel resection due to complications or medical intractability. Moreover, postoperative recurrence is very common, because surgery in CD is not curative. Until now, only few studies investigated postoperative recurrence in CD in Korea. We aimed to assess postoperative recurrence rates - both clinical and endoscopic - in CD and factors influencing postoperative recurrence.
Of 112 CD patients who were regularly followed in St. Vincent hospital, 39 patients had history of previous bowel resection. Among them, 5 patients were excluded from anaysis due to short follow-up period (less than 1 year). Finally, Clinical records of 34 patients were retrospectively analyzed.
Of 34 patients, twenty-six were male (76%) and mean age of onset was 32.8±13.2 years. Mean follow-up period after operation was 65.4±60.6 months. Cumulative clinical recurrence rates were 8.8%, 12.5% and 33.5% at 12, 24 and 48 months. On risk factor analysis, patients who took immunomodulator for prophylaxis showed significantly lower clinical recurrence rates than patients who took 5-Aminosalicylate only (P = 0.031). Of 21 patients who had undergone follow-up colonoscopy after surgery, cumulative endoscopic recurrence rates were 33.3%, 42.9%, and 66.1% at 6, 12 and 24 months. There was no significant predicting factor for endoscopic recurrence.
Postoperative recurrence rates in Korean patients with CD are high, and endoscopic recurrence rates are comparable to those of Western studies. Appropriate medical prophylaxis seems to be important for preventing postoperative recurrence in CD.