Abstract
Purpose
Patients with intestinal Behçet’s disease who underwent intestinal resective surgery often require reoperation. However, there have been no studies on the risk factors and outcomes of early reoperation in these patients.
Methods
We retrospectively evaluated 41 patients with intestinal Behçet’s disease who received repeated intestinal resective surgeries between 2006 and 2016. We analyzed two different patient groups—those who required early reoperation within 6 months and those who underwent reoperation >6 months after the initial surgery—and determined the risk factors for early reoperation.
Results
Eleven patients (26.8%) underwent reoperation within 6 months and 30 patients (73.2%) after 6 months. Emergency surgery at the initial operation and higher initial perioperative erythrocyte sedimentation rate and C-reactive protein levels were significantly associated with early reoperation in the univariate analysis. After the multivariate analysis, initial emergency operation (P = 0.020; hazard ratio [HR], 42.625; 95% confidence interval [CI], 1.817–1000.088) and high erythrocyte sedimentation rate (P = 0.039; HR, 1.049; 95% CI, 1.002–1.097) were determined to be the independent factors for early reoperation.
Conclusions
Emergency surgery and high perioperative erythrocyte sedimentation rate levels were the prognostic factors for early reoperation (within 6 months) in patients with intestinal Behçet’s disease after initial bowel resective surgery.
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References
O'Duffy JD (1994) Behcet’s disease. Curr Opin Rheumatol 6(1):39–43
Kim DH, Cheon JH (2016) Intestinal Behcet’s disease: a true inflammatory bowel disease or merely an intestinal complication of systemic vasculitis? Yonsei Med J 57(1):22–32
Jung YS, Yoon JY, Lee JH, Jeon SM, Hong SP, Kim TI, Kim WH, Cheon JH (2011) Prognostic factors and long-term clinical outcomes for surgical patients with intestinal Behcet’s disease. Inflamm Bowel Dis 17(7):1594–1602
Cheon JH, Kim ES, Shin SJ et al (2009) Development and validation of novel diagnostic criteria for intestinal Behcet’s disease in Korean patients with ileocolonic ulcers. Am J Gastroenterol 104(10):2492–2499
Cheon JH, Shin SJ, Kim SW, Lee KM, Kim JS, Kim WH (2009) Diagnosis of intestinal Behcet’s disease. Korean J Gastroenterol 53(3):187–193
Jung YS, Hong SP, Kim TI, Kim WH, Cheon JH (2012) Early versus late surgery in patients with intestinal Behcet disease. Dis Colon rectum 55(1):65–71
Baek SJ, Kim CW, Cho MS, Jang HA, Baik SH, Hur H, Min BS, Kim NK (2015) Surgical treatment and outcomes in patients with intestinal Behcet disease: long-term experience of a single large-volume center. Dis Colon rectum 58(6):575–581
Iida M, Kobayashi H, Matsumoto T, Okada M, Fuchigami T, Yao T, Fujishima M (1994) Postoperative recurrence in patients with intestinal Behcet’s disease. Dis Colon rectum 37(1):16–21
Smith JA, Siddiqui D (2002) Intestinal Behcet’s disease presenting as a massive acute lower gastrointestinal bleed. Dig Dis Sci 47(3):517–521
Muftuoglu AU, Yazici H, Yurdakul S, Tuzun Y, Pazarli H, Gungen G, Deniz S (1986) Behcet’s disease. Relation of serum C-reactive protein and erythrocyte sedimentation rates to disease activity. Int J Dermatol 25(4):235–239
Liu S, Ren J, Xia Q, Wu X, Han G, Ren H, Yan D, Wang G, Gu G, Li J (2013) Preliminary case-control study to evaluate diagnostic values of C-reactive protein and erythrocyte sedimentation rate in differentiating active Crohn’s disease from intestinal lymphoma, intestinal tuberculosis and Behcet’s syndrome. Am J Med Sci 346(6):467–472
Skef W, Hamilton MJ, Arayssi T (2015) Gastrointestinal Behcet’s disease: a review. World J Gastroenterol 21(13):3801–3812
Author contributions
Guarantor of the article: Jae Hee Cheon
Specific author contributions: Yong Eun Park: acquisition of data; analysis and interpretation of data; drafting of the manuscript. Ji Hoon Lee: study concept and design; critical revision of the manuscript for important intellectual content. Jihye Park: study concept and design; critical revision of the manuscript for important intellectual content. Hyun Jung Lee: study concept and design; critical revision of the manuscript for important intellectual content. Soo Jung Park: study concept and design; critical revision of the manuscript for important intellectual content. Tae Il Kim: study concept and design; critical revision of the manuscript for important intellectual content. Won Ho Kim: study concept and design; critical revision of the manuscript for important intellectual content. Jae Hee Cheon: acquisition of data; study concept and design; critical revision of the manuscript for important intellectual content. All authors approved the final version of the article, including the authorship list.
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This study was approved by the Institutional Review Board of Severance Hospital, Seoul, Korea.
Source of funding
This research was supported by two grants (A120176 and HI13C1345) from the Korean Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), which is funded by the Ministry of Health and Welfare, Republic of Korea; two grants (NRF-2013R1A2A2A01067123 and NRF-2014R1A1A1008096) from the Basic Science Research Program through the National Research Foundation of Korea, which is funded by the Ministry of Science, ICT and Future Planning; a faculty research grant (2012-31-0477) from the Department of Internal Medicine, Yonsei University, College of Medicine.
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The authors declare that they have no conflict of interest.
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Park, Y.E., Cheon, J.H., Park, J. et al. The outcomes and risk factors of early reoperation after initial intestinal resective surgery in patients with intestinal Behçet’s disease. Int J Colorectal Dis 32, 591–594 (2017). https://doi.org/10.1007/s00384-016-2743-y
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DOI: https://doi.org/10.1007/s00384-016-2743-y