Postoperative Recurrence

Recurrence of CD is extremely common and usually occurs proximal to the site of the surgical anastomosis [4]. Endoscopic recurrence has been shown to occur in 73% at 1 year and in 85 % at 3 years. Clinical relapse rates, however, were only 20 and 34% respectively [11]. Similarly, evidence of histological recurrence has not been shown to correlate with clinical recurrence nor has early endoscopic recurrence with the need for later surgical intervention [12].

The most pertinent clinical outcome in the postoperative period is the requirement for reoperation. The need for surgical reintervention follows a similar prevalence relating to the site of disease and mirrors that for the first operation. Thus, ileocolic disease at 53% is generally associated with higher rates of reoperation than isolated colonic (45%) or small bowel disease (44%) [10]. In the National Cooperative Crohn's Disease Study, more than 70% of patients who underwent resection for ileocolitis required a second intervention within 15 years, and the median time to reoperation was between 5 and 10 years [6]. Stric-turing jejunoileal disease is much less common but is recognized as having the highest relapse rates [13,14]

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