Clinical analysis of surgical treatment in patients with isolated colonic Crohn′s disease

Abstract

Objective To investigate the safety and efficacy of different surgical procedures in patients with isolated colonic Crohn′s diseases (CD) , and explore the affecting factors for postoperative surgical recurrence. Methods Clinical data of patients with isolated colonic CD undergoing operation at the General Hospital of Eastern Theater Command from January 2008 to December 2017 were retrospectively analyzed. Morbidity of complication during postoperative 30-day and surgical recurrence during follow-up were compared between patients undergoing segmental colectomy and those undergoing extensive colectomy. The risk factors of postoperative surgical recurrence were analyzed with Log-rank test and Cox regression. Results A total of 41 patients with isolated colonic CD were enrolled, including 19 cases of segmental colectomy and 22 of extensive colectomy. Fifteen (36.6%) patients received permanent ostomy and 27 (65.9%) patients developed postoperative complication. The morbidity of postoperative complication was significantly higher in extensive colectomy group than that in segmental colectomy group (20/22 vs. 7/19, P= 0.002) , while the surgical recurrence was not significantly different between these two groups (4/22 vs. 6/19, P= 0.571) . Male was a risk factor, but not an independent risk factor of postoperative surgical recurrence in patients with isolated colonic CD. Conclusions For isolated colonic CD patients, extensive colectomy is associated with higher morbidity of postoperative complications as compared to segmental colectomy, however, postoperative surgical recurrence between these two operative procedures is similar. Male is a risk factor of postoperative surgical recurrence for patients with isolated colonic CD. Key words: Isolated colonic Crohn′s diseases; Surgical recurrence; Postoperative complications