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Presence of granulomas is associated with recurrence after surgery for Crohn's disease: experience of a surgical unit

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Background The determinants for recurrence of Crohn's disease remain controversial. Eight factors that might predict recurrence were studied in 130 patients operated on for Crohn's disease over a 24-year period.

Methods Separate survival curves were estimated for each variable. A multivariate analysis was then carried out in which several selected explanatory variables were included simultaneously in a proportional hazards regression model.

Results Operation for recurrent disease was necessary in 36 patients. Univariate analysis revealed a highly significant relationship between the presence of granulomas and subsequent recurrence (P=0·003). There was a trend towards increased recurrence in patients with ileocolonic disease and segmental colectomy (P=0·11 and P=0·1 respectively). Age, sex, length of history, indication for operation and affected lines of transection were not associated with recurrence. After multivariate analysis, the association of granulomas with recurrence remained significant (P=0·03). This association persisted when death was regarded as a treatment failure (P=0·02).

Conclusion The presence of granulomas in patients with Crohn's disease is significantly associated with recurrence.
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Document Type: Research Article

Affiliations: 1: Departments of Surgery and 2: Faculty of Medicine, University of Newcastle, Newcastle, New South Wales, Australia 3: Histopathology, The Royal Newcastle Hospital and

Publication date: January 1, 1997

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