Background

Surgical resection for Crohn’s disease (CD) remains non-curative and recurrence remains a significant problem. Although numerous factors affecting surgical outcomes in redo-ileocolic resection were previously described, no study has considered the relation between the interval of time from initial ileocolic resection to the redo procedure and its effect on surgical outcomes. This study aimed to explore this relationship.

Methods

A retrospective review of all adult patients undergoing redo-ileocolic resection for CD between 2011 to 2020 was conducted. Patients were divided into two groups based on time from initial ileocolic resection. Patients operated within 10 years from their initial surgery (≤10 years) were assigned to the early group, while patients operated >10 years were allocated to the late group. Primary outcome was 30-day postoperative major complication rate.

Results

58 patients underwent redo-ileocolic resection, 24 in the early group and 34 in the late group. Aside from older median age in the late group (56 vs 46.5, p=0.026), the groups were similar for patient factors, disease site and behavior, immune-suppressing medication use, and procedural factors. Significant differences in 30-day postoperative morbidity included longer length of stay (6 vs 5 days, p=0.035), higher major complication rate (23.5% vs 4.1%, p=0.04) and higher readmission rate (26.4% vs 4.1%, p=0.035) in the late group. Overall complication rate remained non-significant (37.5% vs 61.8%, p=0.1).

Conclusions

Redo-ileocolic resection, when preformed >10 years from initial ileocolic resection, may be associated with increased morbidity, specifically higher rates of major postoperative complications, longer length of stay, and more readmisions.