EP727 - Clinical analysis of reoperation for postoperative recurrence after initial intestinal resection with Crohn’s disease －prospective study－

Monday, May 12, 2025

10:25 AM – 10:30 AM PT

ePoster Presenter(s)

Akira Sugita, MD. PhD (he/him/his)

Clinical adviser
Dep. of IBD, Yokohama Municipal Citizen's Hospital
The Research Group of Intractable Inflammatory Bowel Disease
Yokohama, Kanagawa, Japan

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

Author(s)

kT

kenji Tatsumi, MD. PhD

Manager
Dep. of IBD, Yokohama Municipal Citizen's Hospital
Yokohama, Kanagawa, Japan

Disclosure information not submitted.
HK

Hirosuke Kuroki, n/a

Manager
Dep. of IBD, Yokohama Municipal Citizen's Hospital
Yokohama, Kanagawa, Japan

Disclosure information not submitted.
KG

Kouki Gotoh, MD. PhD

Stuff
Dep. of IBD, Yokohama Municipal Citizen's Hospital
yokohama, Kanagawa, Japan

Disclosure information not submitted.
NO

Nao Obara, MD. PhD

Stuff
Dep. of IBD, Yokohama Municipal Citizen's Hospital
yokohama, Kanagawa, Japan

Disclosure information not submitted.
EN

Eiichi Nakao, MD. PhD

Stuff
Dep. of IBD, Yokohama Municipal Citizen's Hospital
yokohama, Kanagawa, Japan

Disclosure information not submitted.
KK

Kazutaka Koganei, MD. PhD

Director
Dep. of IBD, Yokohama Municipal Citizen's Hospital
yokohama, Kanagawa, Japan

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Akira Sugita, MD. PhD: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Postoperative recurrence in Crohn’s disease is the important issue because it disturbs patients’ good quality of life and unsolved issues still exist including type of recurrence, risk factors.
This study was conducted prospectively to examine postoperative recurrence after initial intestinal resection including strictureplasty in Crohn’s disease and to clarify the type, risk factors of recurrence for postoperative better treatment.

Methods/Interventions: This prospective study started on December 2016 in our institution with the approval by ethics committee and 141 Crohn’s disease patients with initial intestinal resection including strictureplasty were enrolled. These patients were investigated the issues about smoking (39%), anal lesions (67%), operative indications(perforating indication 48%,non-perforating indication 52%) , operative procedures(small intestinal resection 55%, colonic resection 16%, small and large intestinal resection 29%) including type of anastomosis, the incidence of granuloma in the resected specimen (92%), and postoperative treatments of 5ASA (93%), steroid (23%), azathioprine(38%), enteral nutrition(34%), and anti TNFαtherapy(57%) including for the prevention of recurrence. Postoperative recurrence was evaluated by image study (intestinal series, CT, endoscopy) and reoperation for recurrence. Postoperative median follow-up period was 60 months.

Results/Outcomes: 1. The image study showed 39% recurrence rate (52/132 cases) and median duration for recurrence was 14 months. 2. Reoperation for recurrence underwent in 21% of the patients (30/141). Cumulative reoperation rate was 25% at 5years and 40% at 7 years after initial intestinal resection. Anastomotic resection was performed in 50% of patients (15/30) and resection except anastomosis in 50%. No definite risk factors were confirmed probably because of small number of patients

Conclusion/Discussion: In this prospective study, 5 year cumulative reoperation rate for recurrence was 25% after initial intestinal resection in Crohn’s disease. Anastomotic site was responsible for reoperation in only 50% of patients. Continuous medical treatment and the evaluation for whole intestine including anastomotic site is necessary after intestinal resection in Crohn’s disease.