[Factors affecting the postoperative recurrence of Crohn's disease. New controversies with one centre's experience]. / Factores que afectan a la recurrencia postoperatoria de la enfermedad de Crohn. Nuevas controversias a través de la experiencia de un centro.

INTRODUCTION: Many patients with Crohn's disease have frequent recurrences, while others have long periods of remission after surgery. Determination of the risk factors of recurrence would be useful in identifying these high risk patients and to adopt suitable strategies during the surgical act and in the choice of post-surgical medical treatment. MATERIAL AND METHODS: A retrospective study was conducted on 78 patients with ileocolic Crohn's disease subjected to a first surgical resection, during the period from January 2000 to December 2005. The risk factors for endoscopic, radiological and surgical were subsequently analysed up to May 2009. RESULTS: A total of 41 patients (52.6%) had recurrences, being endoscopic in 17 (21.8%) of patients, radiological in 12 (15.4%) and surgical in 12 (15.4%). The mean time to first recurrence was 70.24 months. Recurrence was associated more to not performing anastomosis (77.7% vs. 48.2%) during surgical resection. Although only the existence of postoperative complications (P=.018) was significantly associated with (68.4% vs. 47.4%), as well as with the need for transfusion in the immediate post-operative period (67.8% vs. 42.8%). CONCLUSIONS: Transfusion of blood products is a risk factor for postoperative recurrence of Crohn's disease. But only postoperative complications are shown as an independent risk factor in the multivariate analysis. An adequate and safe surgical technique is a very important perioperative factor over which we have the influence to decrease these recurrences.