P541 Does smoking increase the need for the use of immunomodulator treatment in Crohn's disease patients?

Abstract

The aim of this study was to compare clinical outcome of patients undergoing early ileocoecal resection to those who had late resection and to determine if the type of ileo colonic anastomosis had an impact on post operative recurrence. Methods: We conducted a retrospective study over 11 years (from 2000 to 2011). We included patients who underwent ileocecal resection during the study period. The data collected were: demographics and disease characteristics (location, phenotype) treatments, indications for surgery and postoperative recurrence. Results: 64 patients were included. There were 31 women and 33 men. The mean age at the first resection was 30.2 years. 8% had familial history of IBD and smoking was found in 32.8% cases. The indications for the resection were ileal obstruction in 40 cases (63%), enteric fistula in 2 (3.1%), enterocutaneous fistula in 2 (3.1%) and intra-abdominal abscess in 19 (29.7%). 43 Patients had an early surgery. The ileo colonic anostomosis was termino-lateral in 67.2%. During follow-up, 43.2% of patients developed a recurrence after surgery with the mean delay of 5 months. The sites of first recurrence were the preanastomotic ileum in 33.3%, the postanastomotic colon in 23.8%. Relapse rates were less frequent in those operated early 32.5% (14/43) VS those operated later 43% (9/21) p: 0.05. Conclusions: An early ileo coecal resection was associated with a reduced risk of clinical recurrence in our study.