The risk factors for complications after Crohn's disease surgery

Abstract

Background: Crohn's disease needs a multidisciplinary approach, and surgery will ultimately be necessary for most patients. Complications usually occur after surgery. Objective: this study aims to present complication rates in surgically treated Crohn's disease patients at a single institution and to determine possible risk factors. Methods: a retrospective analysis of 112 consecutive surgery performed on Crohn's disease patients between 2003 and 2015. The demographic data, patient and disease characteristics, surgery type, and complications were analyzed. Results: of 112 patients, 64 (57.1%) were male and 48 (42.9%) were female. The mean age was 34 (range, 18-78) years. The mean follow-up was 114 6 32.4 (range, 61-197) months. The most common early complications were intra-abdominal abscess formation (n = 10, 8.9%) and wound infection (n=7, 6.26%). The incisional hernia was the most common late complication (n = 4, 3.6%). Nonmodifiable disease features associated with complications were colonic involvement of the disease (P = 0.001), penetrating disease character (P = 0.037), stoma formation (P = 0.000), fistula (P = 0.008), and concomitant fistula and intra- abdominal abscess existence (P = 0.043). Stoma formation was found to be an independent risk factor for complications (P = 0.001). Conclusions: colonic involvement, penetrating disease, fistula, concomitant abscess and fistula, and stoma formation were identified as nonmodifiable risk factors for complications after surgery for Crohn's disease.