The Risk Factors for Complications After Crohn's Disease Surgery

Abstract

Background Crohn's disease needs a multidisciplinary approach, and surgery will ultimately be necessary for most patients. Complications usually occur after surgery. Objective This study aims to present complication rates in surgically treated Crohn's disease patients at a single institution and to determine possible risk factors. Methods A retrospective analysis of 112 consecutive surgery performed on Crohn's disease patients between 2003 and 2015. The demographic data, patient and disease characteristics, surgery type, and complications were analyzed. Results Of 112 patients, 64 (57.1%) were male and 48 (42.9%) were female. The mean age was 34 (range, 18–78) years. The mean follow-up was 114 ± 32.4 (range, 61–197) months. The most common early complications were intra-abdominal abscess formation (n = 10, 8.9%) and wound infection (n = 7, 6.26%). The incisional hernia was the most common late complication (n = 4, 3.6%). Nonmodifiable disease features associated with complications were colonic involvement of the disease (P = 0.001), penetrating disease character (P = 0.037), stoma formation (P = 0.000), fistula (P = 0.008), and concomitant fistula and intra-abdominal abscess existence (P = 0.043). Stoma formation was found to be an independent risk factor for complications (P = 0.001). Conclusions Colonic involvement, penetrating disease, fistula, concomitant abscess and fistula, and stoma formation were identified as nonmodifiable risk factors for complications after surgery for Crohn's disease.