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

Toshiaki Watanabe, Iwao Sasaki, Akira Sugita, Kohei Fukushima, Kitaro Futami, Toshifumi Hibi, Mamoru Watanabe

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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 = 0.0069), postoperative administration of infliximab (P = 0.0030), and the anatomical site of the disease (P = 0.0132) were significant risk factors for the third operation. In multivariate analysis, the interval between the initial and the second operation (P = 0.0287) and postoperative administration of infliximab (P = 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 = 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.

Original languageEnglish
Pages (from-to)17-24
Number of pages8
JournalInflammatory Bowel Diseases
Volume18
Issue number1
DOIs
Publication statusPublished - 2012 Jan

Keywords

  • Crohn's disease
  • reoperation
  • risk factor
  • second surgery
  • surgery
  • time changes
  • time trend

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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