Background: Surgery in Crohn’s disease (CD) may be associated with poor prognosis and clinical and surgical recurrence.
The aim of this study was to describe and compare the post-operative management and outcomes of patients with CD who
underwent first vs recurrent surgeries.
Methods: Observational study that included adult CD patients from 26 Spanish hospitals who underwent ileocolonic resection
with ileocolonic anastomosis between January 2007 and December 2010. Data were retrospectively collected from the
medical records.
Results: Data from 314 patients were analysed, of whom 262 (83%) underwent first surgery and 52 (17%) referred to previous
CD surgeries. Baseline characteristics were similar between the two groups except for a higher rate of stricturing behavior
at diagnosis among re-operated patients (P¼0.03). After surgery, a higher proportion of re-operated patients received prophylactic treatment with immunomodulators compared with patients with first surgery (P¼0.04). In re-operated
patients, time to clinical recurrence was not associated with the fact of receiving or not prophylaxis, whereas, in patients
with first surgery, recurrence-free survival was greater when prophylaxis was received (P¼0.03).
Conclusions: After surgery, a higher proportion of patients with previous surgeries received prophylactic treatment with
immunomodulators compared with patients with first surgery. Although prophylactic treatment was beneficial for
preventing clinical recurrence in patients operated on for the first time, it did not significantly reduce the risk of further
recurrence in patients with previous surgeries. This suggests that effective prophylactic therapies are still needed in this subset of patientsThis study was funded by Merck Sharp & Dohme of Spain, a subsidiary of Merck & Co., Inc., Kenilworth, New Jersey, US
