Jejunal Crohn's disease is associated with a higher postoperative recurrence rate than ileocaecal Crohn's disease

Abstract

The presence of jejunal Crohn's disease is associated with a higher rate of early disease recurrence compared to ileocaecal disease but long-term recurrences rate do not differ significantly.

Frequency, Pattern, and Risk Factors of Postoperative Recurrence of Crohn’s Disease After Resection Different from Ileo-Colonic

“…To our knowledge, only few retrospective studies including a limited number of patients investigated this issue, with conflicting results. [10][11][12][13] The knowledge of the natural history of the postoperative course of CD patients after surgical resection different from the ileo-colonic may be useful for proper clinical management and surgical indications. In order to address this issue, we aimed to assess, in a retrospective analysis, the frequency and pattern of CD recurrence in a cohort of CD patients under regular follow-up.…”

“…10 The few retrospective studies investigating this issue suggest that the recurrence rate in CD patients with colo-colonic anastomosis is lower than in patients with ileo-colonic anastomosis, while the natural history of jejunal CD after surgery appears to run a more aggressive course when compared with patients resected for ileo-cecal CD. [11][12] As upper GI lesions related to CD appears more frequently in younger patients 12 and a lower age at disease onset is being observed during the last few years, 11 the knowledge of the natural history of CD after "curative" resection of the upper small intestine (jejunum or proximal ileum) may add clues for proper indication for surgery, including timing and type of surgical approach. In this retrospective analysis, we aimed to identify the frequency, pattern, and risk factors associated with postoperative disease recurrence in patients with CD during regular clinical follow-up following "curative" resection different from ileo-colonic, including permanent ileostomy.…”

Postoperative Crohn’s disease recurrence: A practical approach

“…When recurrence was defined by the need for reoperation, patients with disease affecting only large bowel had a higher risk when compared to those with isolated small bowel involvement or ileal and colonic disease [24] . The presence of jejunal CD is associated with a higher rate of early disease recurrence as compared to ileocecal disease, but longterm recurrence rates do not differ significantly [25] . In a European study, phenotype at diagnosis had a strong predictive value for clinical relapse or recurrence, upper gastrointestinal disease being the most important positive predictor; although the study did not focus on POR, it seems that these results agree with those obtained in the Japanese study [13] .…”

Managing medical complications and recurrence after surgery for Crohn’s disease

“…In a study of 724 CD patients treated surgically between 1943 and 2002, the reoperation rates for the 28 patients with jejunal CD were 43%, 50%, and 61% at 3, 5, and 10 years, respectively, compared with 22%, 30%, and 51% for the patients with ileocecal disease [26].…”