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

  • Kazuhiro Watanabe
  • Iwao Sasaki
  • Kouhei Fukushima
  • Kitaro Futami
  • Hiroki Ikeuchi
  • Akira Sugita
  • Riichiro Nezu
  • Tsunekazu Mizushima
  • Shingo Kameoka
  • Masato Kusunoki
  • Kazuhiko Yoshioka
  • Yuji Funayama
  • Toshiaki Watanabe
  • Hisao Fujii
  • Mamoru Watanabe
Original Article—Alimentary Tract

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 disease Intestinal failure Short bowel syndrome Home parenteral nutrition Surgery 

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Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Kazuhiro Watanabe
    • 1
  • Iwao Sasaki
    • 1
  • Kouhei Fukushima
    • 1
    • 2
    • 3
  • Kitaro Futami
    • 4
  • Hiroki Ikeuchi
    • 5
  • Akira Sugita
    • 6
  • Riichiro Nezu
    • 7
  • Tsunekazu Mizushima
    • 8
  • Shingo Kameoka
    • 9
  • Masato Kusunoki
    • 10
  • Kazuhiko Yoshioka
    • 11
  • Yuji Funayama
    • 12
  • Toshiaki Watanabe
    • 13
  • Hisao Fujii
    • 14
  • Mamoru Watanabe
    • 15
  1. 1.Department of SurgeryTohoku University HospitalSendaiJapan
  2. 2.Laboratory of GI Tract ReconstructionTohoku University Graduate School of Biomedical EngineeringSendaiJapan
  3. 3.Department of Molecular and Surgical PathophysiologyTohoku University Graduate School of MedicineSendaiJapan
  4. 4.Department of SurgeryFukuoka University Chikushi HospitalFukuokaJapan
  5. 5.Inflammatory Bowel Disease CenterHyogo College of MedicineNishinomiyaJapan
  6. 6.Department of SurgeryYokohama Municipal Citizen’s HospitalYokohamaJapan
  7. 7.Department of SurgeryOsaka Rosai HospitalSakaiJapan
  8. 8.Department of Gastroenterological SurgeryOsaka University HospitalSuitaJapan
  9. 9.Department of Surgery IITokyo Women’s Medical UniversityTokyoJapan
  10. 10.Department of Gastrointestinal and Pediatric SurgeryMie University HospitalTsuJapan
  11. 11.Department of SurgeryKansai Medical University Kouri HospitalOsakaJapan
  12. 12.Department of Colorectal SurgeryTohoku Rosai HospitalSendaiJapan
  13. 13.Department of Surgical OncologyThe University of TokyoTokyoJapan
  14. 14.Department of EndoscopyNara Medical University HospitalKashiharaJapan
  15. 15.Department of GastroenterologyTokyo Medical and Dental UniversityTokyoJapan

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