Time trend and risk factors for reoperation in Crohn's disease in Japan

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

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background/Aims: We aimed to evaluate time changes in reoperation rate after initial surgery in Crohn's disease (CD) over the last five decades in Japan and to assess the risk factors for reoperation, given that a decrease in the reoperation rate for CD remains controversial. Methodology: CD patients (n-476) who underwent initial intestinal surgery were examined. Case records were collected from 13 institutions and scrutinized retrospectively. The primary outcome measure was the reoperation rate needing intestinal surgery. To evaluate the time changes, we compared medical treatment and reoperation rate in patients from two different periods of time; before and after 2002 when infliximab became available in Japan (1963-2002 and 2003-2008 groups). Univariate and multivariate analyses were performed to examine the influence of independent variables on the cumulative reoperation rate. Results: A total of 201 patients underwent reoperation. Overall 5-year and 10-year cumulative reoperation rates were 31.4% and 61.2%, respectively. In multivariate analysis, an onset of the disease between 1963-2002 (p=0.0199) and postoperative administration of infliximab (p=0.0003) and immunosuppressants (p<0.0001) were significant risk factors for re-operation. The cumulative 5-year reoperation rate decreased significantly in the 2003-2008 group compared to the 1963-2002 group (6.3% vs. 32.9%, p<0.05). Conclusions: The reoperation rate for CD has decreased significantly in recent years in Japan. However, to further confirm this time trend, we need to evaluate CD patients with a longer follow-up period.

Original languageEnglish
Pages (from-to)1081-1086
Number of pages6
JournalHepato-Gastroenterology
Volume59
Issue number116
DOIs
Publication statusPublished - 2012 Jun

Keywords

  • Crohn's disease
  • Reoperation
  • Risk factor
  • Second surgery
  • Surgery
  • Time changes
  • Time trend

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Watanabe, T., Sasaki, I., Sugita, A., Fukushima, K., Futami, K., Hibi, T., & Watanabe, M. (2012). Time trend and risk factors for reoperation in Crohn's disease in Japan. Hepato-Gastroenterology, 59(116), 1081-1086. https://doi.org/10.5754/hge10822