Cumulative incidence of second intestinal resection in Crohn's disease: a systematic review and meta-analysis of population-based studies.
Am J Gastroenterol
; 109(11): 1739-48, 2014 Nov.
Article
em En
| MEDLINE
| ID: mdl-25331349
ABSTRACT
OBJECTIVES:
Approximately 50% of Crohn's disease patients undergo an intestinal resection within 10 years of diagnosis. The risk of second surgery in Crohn's disease and the influence of time are not well characterized. We performed a systematic review and meta-analysis to establish the risk of second abdominal surgery in patients with Crohn's disease among patients who had a previous surgery.METHODS:
We searched Medline, EMBASE, PubMed (March 2014), and conference proceedings for terms related to Crohn's disease and intestinal surgery. We included population-based articles (n=11) and an abstract (n=1) reporting surgical risk for the overall study period and for 5 and 10 years after the first surgery for Crohn's disease. We stratified studies by year (start year before vs. after 1980) to explore the role of time.RESULTS:
For all population-based studies, the overall risk of second surgery was 28.7% (95% confidence interval (CI) 22.6-36.6%). The 5-year risk of second surgery was 24.2% (95% CI 22.3-26.4%). The 10-year risk of second surgery was 35.0% (95% CI 31.8-38.6%). A significant difference in the 10-year risk of second surgery was observed over time such that studies conducted after 1980 had a lower risk of second surgery (33.2%; 95% CI 31.2-35.4%) compared with those that started before 1980 (44.6%; 95% CI 37.7-52.7%).CONCLUSIONS:
Approximately one-quarter of Crohn's disease patients who have a first surgery also have a second, and the majority of these surgeries occur within 5 years of the first surgery. The 10-year risk of second surgery is significantly decreasing over time.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos do Sistema Digestório
/
Doença de Crohn
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Am J Gastroenterol
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Canadá