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The Presence of Postoperative Infectious Complications is Associated with the Risk of Early Postoperative Clinical Recurrence of Crohn’s Disease

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Abstract

Background

The purpose of the study was to identify risk factors for early clinical and surgical recurrence in Crohn’s disease (CD) patients who underwent intestinal resection.

Method

This was a retrospective study. Consecutive patients who underwent intestinal resection with a primary anastomosis from January 2011–December 2014 were enrolled. Gender, age at surgery, clinical phenotypes of CD, serum albumin and C-reactive protein level the day before surgery, smoking status at surgery, anastomosis technique, number of anastomoses, details of postoperative complications, the postoperative prophylactic treatment were assessed to figure out risk factors for postoperative clinical and surgical recurrence within 1 year after the initial resection by univariate and then multivariate analysis.

Results

Two hundred and thirty-seven patients were analyzed. The risk of early postoperative clinical recurrence was 2.99 times higher in patients suffered postoperative infectious complications [odds ratio (OR) 2.99; 95% CIs, 1.42–6.32; p = 0.004], while never-smoking was found to be a protective factor for early clinical recurrence (OR 0.326; 95% CIs, 0.18–0.59; p < 0.0001). For surgical recurrence within 1 year after resection, the presence of postoperative intra-abdominal septic complications might be a risk factor (OR 6.77; 95% CIs, 1.61–28.5; p = 0.009). Smoker at surgery was also a risk factor for early surgical recurrence (OR 5.41; 95% CIs, 1.36–21.5; p = 0.017).

Conclusion

The presence of postoperative infectious complications was identified as a possible risk factor for early postoperative clinical recurrence after resection in CD patients.

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Acknowledgements

This study was funded by National Natural Science Foundation of China (81570500 and 81500429).

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Author notes

  1. Zhen Guo and Lei Cao have contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, People’s Republic of China

    Zhen Guo, Lei Cao, Feilong Guo, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu & Jieshou Li

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  1. Zhen Guo
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  2. Lei Cao
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  3. Feilong Guo
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  4. Jianfeng Gong
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  5. Yi Li
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  6. Lili Gu
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  7. Weiming Zhu
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Correspondence to Weiming Zhu.

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Guo, Z., Cao, L., Guo, F. et al. The Presence of Postoperative Infectious Complications is Associated with the Risk of Early Postoperative Clinical Recurrence of Crohn’s Disease. World J Surg 41, 2371–2377 (2017). https://doi.org/10.1007/s00268-017-4026-3

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  • DOI: https://doi.org/10.1007/s00268-017-4026-3

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