Perforating and nonperforating indications in repeated surgeries for Crohn’s disease

Table 1 Characteristics of repeated operations patients with Crohn’s disease

	First surgery (n = 386), %	Second surgery (n = 155), %	Third surgery (n = 41), %	P value
Sex				0.405
Man	290 (76.69)	124 (80.00)	33 (80.49)
Female	96 (23.31)	31 (20.00)	8 (19.51)
Age (year)				0.037
A1 (≤ 16)	5 (1.30)	2 (1.29)	0 (00.00)
A2 (17-40)	264 (68.39)	92 (59.35)	20 (48.78)
A3 (> 40)	117 (30.31)	61 (39.35)	21 (51.22)
Appendectomy				0.152
Yes	76 (19.69)	37 (23.87)	13 (31.70)
No	310 (80.31)	118 (76.13)	28 (68.29)
Smoking history				0.576
Never smoker	320 (82.90)	128 (82.58)	37 (90.24)
Past smoker	49 (12.69)	23 (14.84)	3 (7.32)
Active smoker	17 (4.40)	4 (2.58)	1 (2.44)
Preoperative treatment
Immunomodulator	97 (25.13)	48 (30.97)	12 (29.27)	0.362
Enteral Nutrition	178 (46.11)	80 (51.61)	16 (39.02)	0.288
5-aminosalicylates	32 (8.29)	23 (14.84)	4 (9.76)	0.074
Corticosteroids	49 (12.69)	30 (19.35)	7 (17.07)	0.130
Infliximab	8 (2.07)	5 (3.23)	1 (2.44)	0.743
Perianal disease				0.265
Yes	73 (16.77)	39 (25.16)	9 (21.95)
No	313 (83.22)	116 (74.84)	32 (78.05)
Indication for surgery				0.004
Free perforation	65 (16.83)	9 (5.81)	2 (4.87)
Fistula or abscess	107 (27.72)	78 (50.32)	25 (60.97)
Obstruction	162 (41.96)	57 (36.77)	10 (24.39)
Medical intractability	41 (10.62)	5 (3.23)	1 (2.44)
Hemorrhage	11 (2.85)	6 (3.87)	3 (7.32)
Location				0.028
L1 (ileal)	145 (37.56)	56 (36.13)	10 (24.39)
L2 (colonic)	47 (12.18)	7 (4.52)	5 (12.20)
L3 (ileocolonic)	194 (50.26)	92 (59.35)	26 (63.41)
IASCs				0.569
Yes	27 (6.99)	15 (9.68)	3 (7.32)
No	359 (93.01)	140 (90.32)	38 (92.68)

IASCs: Intra-abdominal septic complications.

Table 2 Univariate and multivariate analysis of risk factors associated with postoperative recurrence after first surgery

Covariates	Univariate			Multivariate
	HR	95%CI	P value	HR	95%CI	P value
Age at diagnosis	1.000	0.987-1.014	0.966
Preoperative duration	1.003	1.000-1.006	0.021	1.002	0.999-1.005	0.112
Age	1.005	0.992-1.018	0.496	1.004	0.991-1.018	0.533
Sex	0.934	0.628-1.387	0.734
Appendectomy	1.288	0.874-1.898	0.200
Smoking history	1.026	0.676-1.558	0.903	1.048	0.670-1.639	0.838
Preoperative treatment	0.915	0.630-1.330	0.642
Perianal disease	0.925	0.606-1.413	0.719	0.951	0.619-1.461	0.819
Location	1.027	0.864-1.222	0.761	1.040	0.871-1.241	0.665
Perforating indication	1.456	1.051-2.016	0.024	1.425	1.015-2.000	0.041
Resection range	0.949	0.799-1.128	0.553
IASCs	0.666	0.381-1.164	0.154

IASCs: Intra-abdominal septic complications.

Table 3 Univariate and multivariate analysis of risk factors associated with postoperative recurrence after second surgery

Covariates	Univariate			Multivariate
	HR	95%CI	P value	HR	95%CI	P value
Preoperative duration	0.998	0.990-1.007	0.666	1.001	0.991-1.011	0.872
Interval from first to second	1.001	0.992-1.010	0.831
Age at diagnosis	1.012	0.984-1.041	0.406
Sex	0.804	0.368-1.755	0.583
Appendectomy	0.822	0.419-1.610	0.567
Smoking history	0.918	0.323-2.606	0.872	1.228	0.371-4.065	0.737
Preoperative treatment	1.349	0.667-2.752	0.405
Perianal disease	1.554	0.673-3.592	0.302	1.448	0.593-3.532	0.416
Age	1.008	0.980-1.036	0.590	1.009	0.977-1.042	0.579
Location	1.130	0.798-1.600	0.491	1.182	0.802-1.742	0.397
Perforating indication	2.036	1.043-3.968	0.037	1.919	0.959-3.846	0.065
Resection range	0.955	0.682-1.337	0.788
IASCs	0.862	0.378-1.966	0.725

IASCs: Intra-abdominal septic complications.