Journal of Gastroenterology

, Volume 49, Issue 2, pp 231–238

Long-term incidence and characteristics of intestinal failure in Crohn’s disease: a multicenter study

Authors

    • Department of SurgeryTohoku University Hospital
  • Iwao Sasaki
    • Department of SurgeryTohoku University Hospital
  • Kouhei Fukushima
    • Department of SurgeryTohoku University Hospital
    • Laboratory of GI Tract ReconstructionTohoku University Graduate School of Biomedical Engineering
    • Department of Molecular and Surgical PathophysiologyTohoku University Graduate School of Medicine
  • Kitaro Futami
    • Department of SurgeryFukuoka University Chikushi Hospital
  • Hiroki Ikeuchi
    • Inflammatory Bowel Disease CenterHyogo College of Medicine
  • Akira Sugita
    • Department of SurgeryYokohama Municipal Citizen’s Hospital
  • Riichiro Nezu
    • Department of SurgeryOsaka Rosai Hospital
  • Tsunekazu Mizushima
    • Department of Gastroenterological SurgeryOsaka University Hospital
  • Shingo Kameoka
    • Department of Surgery IITokyo Women’s Medical University
  • Masato Kusunoki
    • Department of Gastrointestinal and Pediatric SurgeryMie University Hospital
  • Kazuhiko Yoshioka
    • Department of SurgeryKansai Medical University Kouri Hospital
  • Yuji Funayama
    • Department of Colorectal SurgeryTohoku Rosai Hospital
  • Toshiaki Watanabe
    • Department of Surgical OncologyThe University of Tokyo
  • Hisao Fujii
    • Department of EndoscopyNara Medical University Hospital
  • Mamoru Watanabe
    • Department of GastroenterologyTokyo Medical and Dental University
Original Article—Alimentary Tract

DOI: 10.1007/s00535-013-0797-y

Cite this article as:
Watanabe, K., Sasaki, I., Fukushima, K. et al. J Gastroenterol (2014) 49: 231. doi:10.1007/s00535-013-0797-y

Abstract

Background

The aim of this study was to clarify the risk and characteristics of intestinal failure (IF) in patients with Crohn’s disease (CD).

Methods

The present study was a retrospective study in 12 hospitals. CD patients who underwent initial surgery at any of the 12 hospitals between 1970 and 2009 were collected (n = 1,703). Those who developed IF were reviewed (n = 68), and the cumulative risk of IF was analyzed by the Kaplan–Meier method. In addition, IF patients who underwent initial surgery at other hospitals and were then treated at any of the 12 hospitals were also reviewed (n = 33). Thus, a total of 101 IF patients were collected, and the cumulative risk of IF-related death was analyzed.

Results

The cumulative risk of IF after the initial surgery was 0.8 % (5 years), 3.6 % (10 years), 6.1 % (15 years), and 8.5 % (20 years). In CD patients with IF, mean age at initial surgery, IF occurrence, and present age at the time of the study were 28.2, 38.2, and 46.1 years, respectively. The mean number of surgeries per patient was 3.3. The mean length of the remnant small bowel was 163 cm. Twelve IF patients (12 %) had died and the cumulative risk of IF-related death by the time from the occurrence of IF was 1.1 % (3 years), 3.7 % (5 years), 6.5 % (7 years), and 8.9 % (10 years).

Conclusion

The occurrence of IF and IF-related death in CD patients is not rare over the long term. There is a pressing need to develop strategies for the prevention and management of IF.

Keywords

Crohn’s diseaseIntestinal failureShort bowel syndromeHome parenteral nutritionSurgery

Copyright information

© Springer Japan 2013