Br J Surg  2000 Dec;87(12):1697-701 

Risk factors for surgery and recurrence in 907 patients with primary ileocaecal

Crohn's disease.

Bernell O, Lapidus A, Hellers G.

Departments of Surgery and Gastroenterology, Karolinska Institute, Huddinge

University Hospital, S-141 86 Huddinge, Sweden.

BACKGROUND: Previous studies on risk factors for resection and postoperative

recurrence in Crohn's disease have given inconclusive results. The aim of this

study was to assess the risk for resection and postoperative recurrence in the

treatment of ileocaecal Crohn's disease and to define factors affecting the

course of the disease. METHODS: A population-based cohort of 907 patients with

primary ileocaecal Crohn's disease was reviewed retrospectively. RESULTS:

Resection rates were 61, 77 and 83 per cent at 1, 5 and 10 years respectively

after the diagnosis. Relapse rates were 28 and 36 per cent 5 and 10 years after

the first resection. A younger age at diagnosis resulted in a low resection

rate. The presence of perianal Crohn's disease and long resection segments

increased the incidence of recurrence, and resection for a palpable mass and/or

abscess decreased the recurrence rate. A decrease in recurrence rate during the

study period (1955-1989) was observed. CONCLUSION: In ileocaecal Crohn's disease

the probability of resection is high and the risk of recurrence moderate.

Crohn's disease in childhood carries a lower risk of primary resection. Perianal

disease and extensive ileal resection increase the risk of recurrence.