Does Smoking Cessation Reduce Surgical Recurrence After Primary Ileocolic Resection for Crohns Disease?

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Bolckmans, RoelOxford Univ Hosp Natl Hlth Serv Fdn Trust, England (författare)

Does Smoking Cessation Reduce Surgical Recurrence After Primary Ileocolic Resection for Crohns Disease?

Artikel/kapitelEngelska2020

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Lippincott Williams & Wilkins,2020
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LIBRIS-ID:oai:DiVA.org:liu-163660
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-163660URI
https://doi.org/10.1097/DCR.0000000000001547DOI

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Språk:engelska
Sammanfattning på:engelska

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Funding Agencies|National Institute for Health Research Oxford Biomedical Research CentreNational Institute for Health Research (NIHR)
BACKGROUND: Tobacco smoking is a known risk factor for recurrence of Crohns disease after surgical resection. OBJECTIVE: This study assessed the effect of smoking cessation on long-term surgical recurrence after primary ileocolic resection for Crohns disease. DESIGN: A retrospective review of a prospectively maintained database was conducted. SETTINGS: Patient demographic data and medical and surgical details were combined from 2 specialist centers. After ethical approval, patients were contacted in case of missing data regarding smoking habit. PATIENTS: All patients undergoing ileocolic resection between 2000 and 2012 for histologically confirmed Crohns disease were included. Those with previous intestinal resection, strictureplasty for Crohns disease, leak after ileocolic resection, or who were never reversed were excluded. MAIN OUTCOME MEASURES: The primary end point was surgical recurrence measured by Kaplan-Meier survival analysis and secondary medical therapy at time of follow-up. RESULTS: Over a 12-year period, 290 patients underwent ileocolic resection. Full smoking data were available for 242 (83%) of 290 patients. There were 169 nonsmokers (70%; group 1), 42 active smokers at the time of ileocolic resection who continued smoking up to last follow-up (17%; group 2), and 31 (13%) who quit smoking after ileocolic resection (group 3). The median time of smoking exposure after ileocolic resection for group 3 was 3 years (interquartile range, 0-6 y), and median follow-up time for the whole group was 112 months (9 mo; interquartile range, 84-148 mo). Kaplan-Meier survival analysis showed a significantly higher surgical recurrence rate for group 2 compared with group 3 (16/42 (38%) vs 3/31 (10%); p = 0.02; risk ratio = 3.9 (95% CI, 1-12)). In addition, significantly more patients in group 2 without surgical recurrence received immunomodulatory maintenance therapy compared with group 3 (12/26 (46%) vs 4/28 (14%); p = 0.01; risk ratio = 3.2 (95% CI, 1-9)). LIMITATIONS: The study was limited by its retrospective design and small number of patients. CONCLUSIONS: Smoking cessation after primary ileocolic resection for Crohns disease may significantly reduce long-term risk of surgical recurrence and is associated with less use of maintenance therapy. See Video Abstract at http://links.lww.com/DCR/B86.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
Crohns disease; Ileocolic resection; Smoking cessation; Surgical recurrence

Biuppslag (personer, institutioner, konferenser, titlar ...)

Kalman, Thordis DisaLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)diska37 (författare)
Singh, SandeepOxford Univ Hosp Natl Hlth Serv Fdn Trust, England (författare)
Ratnatunga, Keshara C.Oxford Univ Hosp Natl Hlth Serv Fdn Trust, England (författare)
Myrelid, Pär,1970-Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)parmy24 (författare)
Travis, SimonOxford Univ Hosp Natl Hlth Serv Fdn Trust, England (författare)
George, Bruce D.Oxford Univ Hosp Natl Hlth Serv Fdn Trust, England (författare)
Oxford Univ Hosp Natl Hlth Serv Fdn Trust, EnglandAvdelningen för kirurgi, ortopedi och onkologi (creator_code:org_t)

Sammanhörande titlar

Ingår i:Diseases of the Colon & Rectum: Lippincott Williams & Wilkins63:2, s. 200-2060012-37061530-0358

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Av författaren/redakt...: Bolckmans, Roel; Kalman, Thordis ...; Singh, Sandeep; Ratnatunga, Kesh ...; Myrelid, Pär, 19 ...; Travis, Simon; visa fler...; George, Bruce D.; visa färre...

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