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Purpose <p>Studies focusing on surgical recurrence of Crohn’s disease (CD) after ileocecal resection (ICR) are limited. This study aimed to identify the risk factors for long-term CD surgical recurrence following ICR.</p> Methods <p>We retrospectively analyzed 504 patients who underwent ICR for CD between July 2016 and September 2020. The primary outcome was surgical recurrence, and anastomotic recurrence was also evaluated. Survival and associations between clinical factors and outcomes were investigated using Kaplan-Meier analyses and Cox proportional hazards models.</p> Results <p>We observed 76 surgical recurrences with a median follow-up of 75 (67–84 months). The surgical recurrence rate was significantly lower in patients who received prophylactic biologic therapy (<i>P</i> &lt; 0.001). Preoperative anti-TNF exposure (HR, 1.659; 95% CI, 1.029–2.674) and ≥ 2 previous surgeries for CD (HR, 2.236; 95% CI, 1.169–4.277) were associated with an increased risk of surgical recurrence, whereas postoperative biologic prophylaxis was protective against surgical recurrence (HR, 0.206; 95% CI, 0.087–0.488). Primary anastomosis (HR, 0.485; 95% CI, 0.238–0.990) and history of perianal disease (HR, 2.079; 95% CI, 1.011–4.277) were associated with anastomotic surgical recurrence.</p> Conclusions <p>Postoperative biological prophylaxis significantly reduced long-term surgical recurrence rates after ICR in patients with CD, thus emerging as an independent protective factor.</p>

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Risk factors for long-term surgical recurrence following ileocecal resection for Crohn’s disease

  • 期刊论文

  • 发表日期：

    2026年7月31日

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  • Yuhua Huang,
  • Zhizhen Qin,
  • Danhua Yao,
  • Tao Tian,
  • Zeyu Ding,
  • Feilong Guo,
  • Yousheng Li

摘要

Purpose

Studies focusing on surgical recurrence of Crohn’s disease (CD) after ileocecal resection (ICR) are limited. This study aimed to identify the risk factors for long-term CD surgical recurrence following ICR.

Methods

We retrospectively analyzed 504 patients who underwent ICR for CD between July 2016 and September 2020. The primary outcome was surgical recurrence, and anastomotic recurrence was also evaluated. Survival and associations between clinical factors and outcomes were investigated using Kaplan-Meier analyses and Cox proportional hazards models.

Results

We observed 76 surgical recurrences with a median follow-up of 75 (67–84 months). The surgical recurrence rate was significantly lower in patients who received prophylactic biologic therapy (P < 0.001). Preoperative anti-TNF exposure (HR, 1.659; 95% CI, 1.029–2.674) and ≥ 2 previous surgeries for CD (HR, 2.236; 95% CI, 1.169–4.277) were associated with an increased risk of surgical recurrence, whereas postoperative biologic prophylaxis was protective against surgical recurrence (HR, 0.206; 95% CI, 0.087–0.488). Primary anastomosis (HR, 0.485; 95% CI, 0.238–0.990) and history of perianal disease (HR, 2.079; 95% CI, 1.011–4.277) were associated with anastomotic surgical recurrence.

Conclusions

Postoperative biological prophylaxis significantly reduced long-term surgical recurrence rates after ICR in patients with CD, thus emerging as an independent protective factor.