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

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Fältnamn	Indikatorer	Metadata
000		04684naa a2200373 4500
001		oai:DiVA.org:liu-163660
003		SwePub
008		200218s2020 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-1636602 URI
024	7	a https://doi.org/10.1097/DCR.00000000000015472 DOI
040		a (SwePub)liu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Bolckmans, Roelu Oxford Univ Hosp Natl Hlth Serv Fdn Trust, England4 aut
245	1 0	a Does Smoking Cessation Reduce Surgical Recurrence After Primary Ileocolic Resection for Crohns Disease?
264	1	b Lippincott Williams & Wilkins,c 2020
338		a print2 rdacarrier
500		a Funding Agencies\|National Institute for Health Research Oxford Biomedical Research CentreNational Institute for Health Research (NIHR)
520		a 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.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kirurgi0 (SwePub)302122 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Surgery0 (SwePub)302122 hsv//eng
653		a Crohns disease; Ileocolic resection; Smoking cessation; Surgical recurrence
700	1	a Kalman, Thordis Disau Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US4 aut0 (Swepub:liu)diska37
700	1	a Singh, Sandeepu Oxford Univ Hosp Natl Hlth Serv Fdn Trust, England4 aut
700	1	a Ratnatunga, Keshara C.u Oxford Univ Hosp Natl Hlth Serv Fdn Trust, England4 aut
700	1	a Myrelid, Pär,d 1970-u Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US4 aut0 (Swepub:liu)parmy24
700	1	a Travis, Simonu Oxford Univ Hosp Natl Hlth Serv Fdn Trust, England4 aut
700	1	a George, Bruce D.u Oxford Univ Hosp Natl Hlth Serv Fdn Trust, England4 aut
710	2	a Oxford Univ Hosp Natl Hlth Serv Fdn Trust, Englandb Avdelningen för kirurgi, ortopedi och onkologi4 org
773	0	t Diseases of the Colon & Rectumd : Lippincott Williams & Wilkinsg 63:2, s. 200-206q 63:2<200-206x 0012-3706x 1530-0358
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-163660
856	4 8	u https://doi.org/10.1097/DCR.0000000000001547

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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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