Intestinal Research

Clinical and Endoscopic Recurrence after Surgical Resection in Patients with Crohn's Disease: Yang Woon Lee, Kang-Moon Lee, Woo Chul Chung, Chang Nyol Paik, Hea Jung Sung, You Suk Oh; Intest Res 2014;12(2):117-123. Published online April 29, 2014; DOI: https://doi.org/10.5217/ir.2014.12.2.117

<b>Background/Aims</b><br/>

The natural history of Crohn's disease (CD) is characterized by a remitting and relapsing course and a considerable number of patients ultimately require bowel resection. Moreover, postoperative recurrence is very common. Relatively few studies have investigated the postoperative recurrence of CD in Korea. The aim of the current study was to assess postoperative recurrence rates - both clinical and endoscopic - in CD as well as factors influencing postoperative recurrence.

Methods

Electronic medical records of patients who underwent surgery due to CD were reviewed and analyzed. Patients with incomplete surgical resection, a follow-up period of less than a year, and a history of strictureplasty or perianal surgery were excluded.

Results

Of 112 CD patients, 39 patients had history of bowel resection, and 34 patients met the inclusion criteria. Among them, 26 were male (76%) and the mean age of onset was 32.8 years. The mean follow-up period after operation was 65.4 months. Cumulative clinical recurrence rates were 8.8%, 12.5%, and 33.5% at 12, 24, and 48 months, respectively. Use of immunomodulators for prophylaxis was the only predictor of clinical recurrence in univariate analysis (P=0.042). Of 21 patients who had undergone follow-up colonoscopy after surgery, cumulative endoscopic recurrence rates were 33.3%, 42.9%, and 66.1% at 6, 12, and 24 months, respectively. No significant predicting factor for endoscopic recurrence was detected.

Conclusions

Postoperative recurrence rates in Korean patients with CD are high, and endoscopic recurrence rates are comparable to those reported from Western studies. Appropriate medical prophylaxis seems to be important for preventing postoperative recurrence in CD.

Citations

Citations to this article as recorded by

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Author's Reply
Kang-Moon Lee
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The Inflamed Appendiceal Orifice does not Always Suggest Acute Appendicitis: Min Huh, Bo-In Lee, Kyu Yong Choi, Kyoung Mee Kim, Jeong Seon Ji, Byung Wook Kim, Hwang Choi, Se Hyun Cho, Woo Chul Chung, Kang Moon Lee, Sok Won Han, In Sik Chung; Intest Res 2006;4(1):39-44. Published online June 30, 2006

Abstract PDF: Background/Aims
Colonoscopy may be helpful in the diagnosis of appendicitis occasionally. However, it is unclear that isolated inflammation at the appendiceal orifice is always suggestive of acute appendicitis. Methods: Eighteen consecutive patients with colonoscopic findings of the isolated inflammatory lesion in the area of the appendiceal orifice were included. Surgical- pathology-proven appendicitis within 6 months after the colonoscopy were defined as 'true-appendicitis'. Results: Of the 18 patients, 16 patients were followed up for more than 6 months. Seven patients underwent appendectomy within 5-79 days after the colonoscopy. Of these, 4 patients (25%) had true-appendicitis, one periappendiceal abscess without appendicitis, two normal appendices. Nine patients did not take appendectomy. Of these, no definite etiology was defined in 6. Of the rest, one patient revealed Crohn's disease, one Behcet's disease and one cecal involvement of distal ulcerative colitis later. Conclusions: Isolated inflammation at the appendiceal orifice does not always suggest acute appendicitis but diverse etiologies. The diagnosis of appendicitis should not be made only by colonoscopic findings but also by clinical course and other imaging studies. (Intestinal Research 2006;4:39-44)

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A Case of Large Polypoid Arteriovenous Malformation of Colon Treated with Detachable Snare: Jeong Seon Ji, Bo In Lee, Byung Wook Kim, Hwang M.D., Se Hyun Cho, Kyu Yong Choi, Woo Chul Chung, Kang Moon Lee, Hyun Suk Chae, In Sik Chung, Kyong Mee Kim; Intest Res 2004;2(1):36-39. Published online April 16, 2004

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A Case of Bacterial Overgrowth Syndrome Presenting Recurrent Edema and Hypoproteinemia After Billoth II Operation: Bo In Lee, Kyu Yong Choi, Byung Wook Kim, Hwang Choi, Se Hyun Cho, Woo Chul Chung, Kang Moon Lee, Soo Heon Park, Hyun Suk Chae, Myung Gyu Choi, In Sik Jung; Intest Res 2003;1(2):197-200. Published online November 27, 2003

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Rapid Growth of Early Colorectal Cancer in a Short Period: a Case Report: Bo In Lee, Kyu Yong Choi, Byung Wook Kim, Hwang Choi, Se Hyun Cho Cho, Woo Chul Chung Chung, Kang Moon Lee, Soo Heon Park, Hyun Suk Chae, Myung Gyu Choi, In Sik Jung; Intest Res 2003;1(1):64-67. Published online May 27, 2003

Abstract PDF: Retrospective studies report that doubling time of early colorectal cancer is 26 months. Recently we experienced a case of early colorectal cancer which increased over twofold in a size in only 13 days. (Intestinal Research 2003;1:64-67)

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