Surgical treatment and outcomes in patients with intestinal behçet disease

Long-term experience of a single large-volume center

Se-Jin Baek, Chang Woo Kim, Min Soo Cho, Hyun A. Jang, Seung Hyuk Baik, Hyuk Hur, Byung Soh Min, Nam Kyu Kim

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: few studies have examined the surgical treatment of intestinal Behçet disease. Consequently, there is currently no standard surgical treatment for intestinal Behçet disease. instead, treatment is empirical and symptom based. OBJECTIVE: our aim was to evaluate the clinical course after surgery and determine the appropriate surgical options for intestinal Behçet disease. DESIGN: medical charts of patients who underwent surgery for intestinal Behçet were retrospectively reviewed. SETTINGS: the study was conducted at a tertiary referral center. PATIENTS: ninety-one patients who underwent surgical treatment for intestinal Behçet disease between January 1995 and December 2012 were included in this study. MAIN OUTCOME MEASURES: Primary outcomes measured were patient demographics, clinical characteristics, operative and postoperative outcomes, and long-term follow-up data. RESULTS: surgical treatment was mainly in response to intractability to medical treatment (56.0%), and 19.8% of patients underwent an emergency operation. surgery was performed laparoscopically in 33.0% of the patients. most patients received an ileocecectomy (39.6%) or a right hemicolectomy (34.1%). twenty-eight patients (30.8%) experienced postoperative morbidities, and 8 patients (8.8%) required reoperations. there were 3 deaths. Reoperation was required for recurrent disease in 32 patients during the long-term follow-up, and the 5-year cumulative reoperation rate was 31.2% (95% Ci, 20.4%-42.0%). among those requiring a second operation, 53.1% were segmental colonic resections that included the previous anastomosis. from multivariable Cox regression analysis, independent predictors of surgical recurrence included postoperative use of steroids (hR = 2.85 (95% Ci, 1.21-6.75); p = 0.02), postoperative complications (hR = 2.42 (95% Ci, 1.12-5.22); p = 0.03), and Bmi (hR per 1-kg/m2 increase in Bmi = 0.90 (95% Ci, 0.82-0.99); p = 0.04). LIMITATIONS: this study was designed retrospectively and had a small sample size. CONCLUSIONS: Patients treated surgically for intestinal Behçet disease frequently have postoperative complications and the need for a stoma and have a high risk of recurrence.

Original languageEnglish
Pages (from-to)575-581
Number of pages7
JournalDiseases of the colon and rectum
Volume58
Issue number6
DOIs
Publication statusPublished - 2015 Jan 1
Externally publishedYes

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Intestinal Diseases
Reoperation
Therapeutics
Recurrence
Tertiary Care Centers
Sample Size
Emergencies
Steroids
Regression Analysis
Demography
Morbidity

Keywords

  • Intestinal Behçet disease
  • Recurrence
  • Reoperation
  • surgery

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Surgical treatment and outcomes in patients with intestinal behçet disease : Long-term experience of a single large-volume center. / Baek, Se-Jin; Kim, Chang Woo; Cho, Min Soo; Jang, Hyun A.; Baik, Seung Hyuk; Hur, Hyuk; Min, Byung Soh; Kim, Nam Kyu.

In: Diseases of the colon and rectum, Vol. 58, No. 6, 01.01.2015, p. 575-581.

Research output: Contribution to journalArticle

Baek, Se-Jin ; Kim, Chang Woo ; Cho, Min Soo ; Jang, Hyun A. ; Baik, Seung Hyuk ; Hur, Hyuk ; Min, Byung Soh ; Kim, Nam Kyu. / Surgical treatment and outcomes in patients with intestinal behçet disease : Long-term experience of a single large-volume center. In: Diseases of the colon and rectum. 2015 ; Vol. 58, No. 6. pp. 575-581.
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abstract = "Background: few studies have examined the surgical treatment of intestinal Beh{\cc}et disease. Consequently, there is currently no standard surgical treatment for intestinal Beh{\cc}et disease. instead, treatment is empirical and symptom based. OBJECTIVE: our aim was to evaluate the clinical course after surgery and determine the appropriate surgical options for intestinal Beh{\cc}et disease. DESIGN: medical charts of patients who underwent surgery for intestinal Beh{\cc}et were retrospectively reviewed. SETTINGS: the study was conducted at a tertiary referral center. PATIENTS: ninety-one patients who underwent surgical treatment for intestinal Beh{\cc}et disease between January 1995 and December 2012 were included in this study. MAIN OUTCOME MEASURES: Primary outcomes measured were patient demographics, clinical characteristics, operative and postoperative outcomes, and long-term follow-up data. RESULTS: surgical treatment was mainly in response to intractability to medical treatment (56.0{\%}), and 19.8{\%} of patients underwent an emergency operation. surgery was performed laparoscopically in 33.0{\%} of the patients. most patients received an ileocecectomy (39.6{\%}) or a right hemicolectomy (34.1{\%}). twenty-eight patients (30.8{\%}) experienced postoperative morbidities, and 8 patients (8.8{\%}) required reoperations. there were 3 deaths. Reoperation was required for recurrent disease in 32 patients during the long-term follow-up, and the 5-year cumulative reoperation rate was 31.2{\%} (95{\%} Ci, 20.4{\%}-42.0{\%}). among those requiring a second operation, 53.1{\%} were segmental colonic resections that included the previous anastomosis. from multivariable Cox regression analysis, independent predictors of surgical recurrence included postoperative use of steroids (hR = 2.85 (95{\%} Ci, 1.21-6.75); p = 0.02), postoperative complications (hR = 2.42 (95{\%} Ci, 1.12-5.22); p = 0.03), and Bmi (hR per 1-kg/m2 increase in Bmi = 0.90 (95{\%} Ci, 0.82-0.99); p = 0.04). LIMITATIONS: this study was designed retrospectively and had a small sample size. CONCLUSIONS: Patients treated surgically for intestinal Beh{\cc}et disease frequently have postoperative complications and the need for a stoma and have a high risk of recurrence.",
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N2 - Background: few studies have examined the surgical treatment of intestinal Behçet disease. Consequently, there is currently no standard surgical treatment for intestinal Behçet disease. instead, treatment is empirical and symptom based. OBJECTIVE: our aim was to evaluate the clinical course after surgery and determine the appropriate surgical options for intestinal Behçet disease. DESIGN: medical charts of patients who underwent surgery for intestinal Behçet were retrospectively reviewed. SETTINGS: the study was conducted at a tertiary referral center. PATIENTS: ninety-one patients who underwent surgical treatment for intestinal Behçet disease between January 1995 and December 2012 were included in this study. MAIN OUTCOME MEASURES: Primary outcomes measured were patient demographics, clinical characteristics, operative and postoperative outcomes, and long-term follow-up data. RESULTS: surgical treatment was mainly in response to intractability to medical treatment (56.0%), and 19.8% of patients underwent an emergency operation. surgery was performed laparoscopically in 33.0% of the patients. most patients received an ileocecectomy (39.6%) or a right hemicolectomy (34.1%). twenty-eight patients (30.8%) experienced postoperative morbidities, and 8 patients (8.8%) required reoperations. there were 3 deaths. Reoperation was required for recurrent disease in 32 patients during the long-term follow-up, and the 5-year cumulative reoperation rate was 31.2% (95% Ci, 20.4%-42.0%). among those requiring a second operation, 53.1% were segmental colonic resections that included the previous anastomosis. from multivariable Cox regression analysis, independent predictors of surgical recurrence included postoperative use of steroids (hR = 2.85 (95% Ci, 1.21-6.75); p = 0.02), postoperative complications (hR = 2.42 (95% Ci, 1.12-5.22); p = 0.03), and Bmi (hR per 1-kg/m2 increase in Bmi = 0.90 (95% Ci, 0.82-0.99); p = 0.04). LIMITATIONS: this study was designed retrospectively and had a small sample size. CONCLUSIONS: Patients treated surgically for intestinal Behçet disease frequently have postoperative complications and the need for a stoma and have a high risk of recurrence.

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