Abstract: Objective:To investigate the surgeryrelated complications and risk factors of ileocolic Crohn′s disease (CD).
Methods:The retrospective casecontrol study was conducted. The clinicopathological data of 52 patients with ileocolic CD who underwent surgery at the Peking Union Medical College Hospital from January 2010 to April 2016 were collected. Observation indicators: (1) surgeryrelated complications, (2) risk factors analysis of surgeryrelated complications: gender, age of onset, preoperative body mass index (BMI), course of disease, smoking history, history of appendectomy, perianal lesions, oral ulcer, Creactive protein (CRP), erythrocyte sedimentation rate, disease behavior, short crohn′s disease activity index (sCDAI), preoperative amino salicylic acid therapy, preoperative hormone therapy, preoperative antituberculosis therapy, preoperative immunosuppressive agents therapy, preoperative biologic agents therapy, emergency operation, surgical method and ileocolic anastomosis method, (3) followup. The followup using outpatient examination and telephone interview was performed to detect recurrence of disease up to August 2016. Measurement data with normal distribution were represented as ±s. The univariate analysis was done using the chisquare test, and multivariate analysis was done using the Logistic regression model.
Results:(1) Surgeryrelated complications: of 52 patients, 12 had postoperative complications. Four patients complicated with wound infection had good healing of the wound after debridement and dressing change. Of 4 patients with abdominal infection, 3 were improved by antiinfection symptomatic treatment and 1 die of septic shock at postoperative day 1. One patient with intestinal obstruction had a smooth recovery after open adhesiolysis. One patient with intestinal fistula discharged from hospital due to a critical condition under families′ requestion. One patient with acute cholecystitis and 1 with acute pancreatitis were respectively improved by conservative treatment. (2) Risk factors analysis of surgeryrelated complications: the result of univariate analysis showed that sCDAI and emergency operation were the factors infecting surgeryrelated complications of ileocolic CD (χ²= 6.299, 8.494, P<0.05）. The result of multivariate analysis showed that sCDAI was an independent factor infecting surgeryrelated complications of ileocolic CD ［OR=2.716, 95% confidence interval (CI): 1.216- 6.066, P<0.05］. (3) Followup: all the 52 patients were followed up for 5-76 months with a median time of 39 months. During the followup, 15 had recurrence of diseases and then underwent medical treatment.
Conclusions:Patients with ileocolic CD are easily complicated with wound infection and abdominal infection in the active period, and sCDAI is an independent factor infecting surgeryrelated complications of ileocolic CD.