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Session: ePoster: IBD 6 (Sat315)

EP133 - Comparing Surgical Outcomes Between Crohn's diease and Gastrointestinal Behçet's disease: A single-Center Retrospective Cohort Study

Saturday, May 10, 2025
3:25 PM – 3:30 PM PT
Location: Monitor 5, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Donghyun Shin, MD (he/him/his)

    fellow
    Severance hospital
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Seungyeon Kang, MD (she/her/hers)

    Fellow
    Severance Hospital, Yonsei university
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • JK

    Jihye Kim, n/a

    Fellow
    Severance Hospital
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    Disclosure information not submitted.

  • HB

    Hyeon Woo Bae, n/a

    Fellow
    Severance Hospital
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Min Young Park

    Clinical assistant professor
    Severance Hospital
    Mapo-gu, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • SY

    Seung Yoon Yang, n/a

    Clinical assistant professor
    Severance Hospital
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • YH

    Yoon Dae Han, n/a

    Facalty
    Severance Hospital
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • HH

    Hyuk Hur, n/a

    Professor
    Severance Hospital
    s, Seoul-t'ukpyolsi, Republic of Korea

    Disclosure information not submitted.

  • BM

    Byung Soh Min, n/a

    Professor
    Severance Hospital
    Seodaemun gu, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • MC

    Min Soo Cho, n/a

    Assistant Professor
    Severance Hospital
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Donghyun Shin, MD: This individual has no financial relationships with ineligible companies.
Seungyeon Kang, MD: This individual has no financial relationships with ineligible companies.
Hyeon Woo Bae, n/a: This individual has no financial relationships with ineligible companies.
Min Young Park: This individual has no financial relationships with ineligible companies.
Seung Yoon Yang, n/a: This individual has no financial relationships with ineligible companies.
Yoon Dae Han, n/a: This individual has no financial relationships with ineligible companies.
Byung Soh Min, n/a: This individual has no financial relationships with ineligible companies.
Min Soo Cho, n/a: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Crohn's disease (CD) and gastrointestinal Behçet's disease (GIBD) are chronic inflammatory bowel disorders with similar clinical presentations and treatment guidelines. However, empirical observations suggest potentially worse postoperative outcomes in GIBD patients. This study aimed to compare long-term surgical outcomes between CD and GIBD patients undergoing primary bowel resection.

Methods/Interventions: We conducted a retrospective cohort study of patients who underwent primary bowel resection for CD or GIBD at a single center between 2001 and 2021. CD was confirmed by pathology, while GIBD was diagnosed using colonoscopic criteria and clinical manifestations based on a modified Delphi process. Clinical recurrence was defined as symptom recurrence/worsening with radiologic or endoscopic evidence. Surgical recurrence was defined as reoperation due to disease recurrence/progression, excluding reoperations for postoperative complications.
Patient demographics, perioperative variables, and postoperative outcomes were compared between CD (n=183) and GIBD (n=73) groups using t-tests and chi-square tests. Cumulative incidence functions were used to analyze recurrence rates. Propensity score matching (PSM) was performed to adjust for baseline differences. Logistic regression, Cox proportional hazards models, and Kaplan-Meier survival analyses were conducted on the PSM cohort.

Results/Outcomes: GIBD patients were significantly older at diagnosis (38.37 vs 25.06 years, p< 0.001) and operation (45.96 vs 30.12 years, p< 0.001), had longer disease duration (95.76 vs 62.80 months, p=0.005), higher BMI (21.27 vs 19.03, p< 0.001), and lower preoperative hemoglobin (10.29 vs 11.51 g/dL, p< 0.001) compared to CD patients. Postoperative hospital stay was longer in the GIBD group (19.93 vs 10.36 days, p=0.003).
Clinical recurrence rates were higher in GIBD patients (67.1% vs 48.1%, p=0.008), as were surgical recurrence rates (20.7% vs 8.7%, p< 0.001). Cumulative incidence function analysis showed significantly higher recurrence rates in GIBD (Gray's test, p< 0.001 for both clinical and surgical recurrence).
After PSM (n=30 per group), there were no significant differences in postoperative complications or recurrence rates. However, survival analysis revealed that GIBD patients had significantly lower clinical recurrence-free survival (HR 1.97, 95% CI 1.02-3.78, p=0.042) and a trend towards lower surgical recurrence-free survival (HR 3.62, 95% CI 0.98-13.41, p=0.054). Kaplan-Meier analysis confirmed significantly lower recurrence-free survival in GIBD patients for both clinical and surgical recurrence (log-rank p=0.039 for both).

Conclusion/Discussion: Despite similar postoperative complication rates, GIBD patients demonstrated significantly higher clinical and surgical recurrence rates compared to CD patients after primary bowel resection. These findings persisted after adjusting for baseline differences through PSM, particularly in time-to-event analyses. The results suggest that GIBD may have a more aggressive postoperative course than CD, highlighting the need for disease-specific management strategies. Future prospective studies are warranted to validate these findings and develop tailored treatment guidelines for GIBD patients undergoing surgical intervention.