Time Trend and Risk Factors of Initial Surgery for Crohn’s Disease in Japan

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Clinical Gastroenterology Journal (formerly Journal of Colitis & Diverticulitis) is a peer reviewed, open access journal considering research on all aspects of digestive system, gastrointestinal diseases, liver, bilary tract, pancreas, diseases of related organs Ulcer medicine, Colitis, Diverticulitis and associated disorders and their treatment. The Journal aims to provide a platform for the exchange of scientific information addressing clinical research and practice of Gastroenterology and Hepatology.

We are sharing one of the most cited article from our journal. Article entitled “Time Trend and Risk Factors of Initial Surgery for Crohn’s Disease in Japan” was well written by Dr. Yutaka Yan.

Abstract

Objective: It is unclear whether the initial surgical rate for CD in Japan has decreased. The present study investigated time trend of background factors and risk factors of initial surgery for CD patients.

Methods: A total of 424 patients diagnosed with CD in our department over the last 20 years who had not undergone surgery were analyzed. The cumulative initial surgery rate was determined using the Kaplan-Meier method. Patients were analyzed to identify risk factors for initial intestinal surgery. Patients diagnosed between 1992 and 2001 were classified into the pre-biological era group (PRE) (n=248), and those diagnosed between 2002 and 2011 into the post-biological era group (POST) (n=176). The groups were compared regarding background factors and reason for initial surgery.

Results: The patients included 303 men and 121 women and a mean length of follow-up of 5.5 ± 4.8 years. The comparison of background characteristics between the PRE group and the POST group for each factor demonstrated a significant increase in inflammatory Crohn’s disease in the POST group (47.6% vs. 61.9%; p=0.007). Cumulative initial surgery rates by era did not differ between the two groups, at 21.0% and 30.5% at 3 and 5 years, respectively, in the PRE group and 26.7% and 38.5% at 3 and 5 years, respectively, in the POST group. However, the surgery rate in patient with biologics treatment such as infliximab and adalimumab was significantly lower than that of patient without biologics at 5 year (8.6% vs. 37.9%; p<0.001)

Conclusions: A significant increase in the proportion of inflammatory type CD was observed in patients diagnosed in 2002 or later. The initial surgery rate for the treatment of CD in Japan has not yet decreased over time. However, CD patients who could undergo biologic maintenance treatment had a better prognosis than their untreated counterparts.

 

Here is the link to view complete article: https://www.hilarispublisher.com/open-access/time-trend-and-risk-factors-of-initial-surgery-for-crohns-disease-in-japan.pdf

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