Abstract
Abstract Background Surgical recurrence after primary ileocolic resection (ICR) for CD is common. (1) However, data on long-term outcomes following first resection of the neoterminal ileum (re-ICR) are scarce. The present study evaluated the risk on surgical recurrence following first re-ICR in CD patients. In addition we aimed to assess changes in medical treatment strategies and its effect on postoperative outcomes. Methods A retrospective cohort study was conducted in the Amsterdam UMC, including all CD patients undergoing first re-ICR between 2000-2021. The primary outcome was the need for re-ICR due to disease recurrence at the neoterminal ileum. Two time periods were created to assess changes in surgical recurrence and short-term outcomes over time, C1: 2000-2009 and C2: 2010-2021. Results in total, 110 patients were included, comprising 69 females (62.7%) with a median age at time of re-ICR of 39 years (IQR 30.0 – 50.3). Time from primary ICR to re-ICR increased significantly over time. Most patients presented with stricturing disease at time of first re-ICR (64.5%). Rates of surgical recurrence were 13.0% and 24.9% after 5 and 10 years, respectively. Over time an increased use of prophylactic biological use was observed (C1: 16.4% vs C2: 41.7%, p=0.004). Over time, no significant differences in 5-year, and 10 year surgical recurrence rates were observed between C1 and C2, (12.5% vs 11.5%, p=0.636), and (28.6% vs 18.7%, p=0.341), respectively. Conclusion This study demonstrated an overall 10-year surgical recurrence rate of 24.9% in patients undergoing first re-ICR. Over time, postoperative disease management has evolved towards increasing use of biological therapy. However, no significant difference in surgical recurrence rates over time have been observed.
Published Version
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