Abstract
Crohn's disease is associated with high rates of postoperative recurrence. By 10 years postoperatively a high percentage of patients suffer clinical relapses (as many as 75% and above) and many of these (up to 45%) require re-intervention. The aim of the study was to identify, among the various potentially predictive factors, those which today can be considered real risk factors for postoperative recurrence. A review of the literature of the last two decades was carried out. Factors related to the patient, disease, type of surgery and pharmacological treatment were analysed. The relapse rate we recorded was 41.17% (28 of 62 patients operated on in the last 20 years and included in an average 6-year follow-up (range: 1-19 years). Significant predictive factors, in adition to duration of the follow-up and smoking, are also the location of the disease in the colon, extent more than 100 cm and the absence of postoperative pharmacological prophylaxis. The high incidence of postoperative recurrence in Crohn's disease mandates a strict follow-up (clinical, laboratory and instrumental monitoring). Identifying patients at increased risk would enable physicians to implement a rational pharmacological prophylaxis.
Publication types
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Comparative Study
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Evaluation Study
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Review
MeSH terms
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Adolescent
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Adult
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Aged
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Anti-Infective Agents / administration & dosage
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Anti-Infective Agents / therapeutic use
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Anti-Inflammatory Agents / administration & dosage
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Anti-Inflammatory Agents / therapeutic use
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Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
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Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
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Antibodies, Monoclonal / administration & dosage
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Antibodies, Monoclonal / therapeutic use
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Crohn Disease / drug therapy*
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Crohn Disease / surgery*
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Female
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Follow-Up Studies
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Forecasting
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Gastrointestinal Agents / administration & dosage
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Gastrointestinal Agents / therapeutic use
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Humans
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Immunosuppressive Agents / administration & dosage
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Immunosuppressive Agents / therapeutic use
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Infliximab
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Laparoscopy
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Male
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Mesalamine / administration & dosage
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Mesalamine / therapeutic use
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Metronidazole / administration & dosage
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Metronidazole / therapeutic use
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Middle Aged
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Postoperative Care
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Randomized Controlled Trials as Topic
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Recurrence
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Reoperation
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Retrospective Studies
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Risk Factors
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Time Factors
Substances
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Anti-Infective Agents
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Anti-Inflammatory Agents
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Anti-Inflammatory Agents, Non-Steroidal
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Antibodies, Monoclonal
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Gastrointestinal Agents
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Immunosuppressive Agents
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Metronidazole
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Mesalamine
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Infliximab