Early ileal resection for Crohn’s disease poses no risk of repeat resection

Patients with Crohn’s disease who underwent early ileal resection are not at increased risk of a repeat resection, according to a retrospective study.

The study included 393 patients who underwent ileocaecal resection or segmental ileal resection within 5 years of diagnosis. These patients were grouped according to the timing of resection: early (within 6 months of diagnosis), intermediate (between 6 months and 2 years), and late (between 2 and 5 years).

The cumulative risk of a second ileal surgery was the primary study endpoint. Secondary endpoints were the use of postoperative treatments and morphological recurrence after initial surgery (Rutgeerts score ≥i2, or recurrence on imaging).

Of the patients, 130 had early resection, 128 had intermediate resection, and 135 had late resection. The cumulative risk of second surgery at 10 years in the early resection group (25.0 percent, 95 percent confidence interval [CI], 17.4–35.2) did not significantly differ with that in the intermediate (16.8 percent, 95 percent CI, 10.5–26.2; p=0.17) or late resection group (22.7 percent, 95 percent CI, 15.1–33.3; p=0.83).

Compared with the late resection group, the early resection group required significantly fewer postoperative treatments (median survival without treatment, 3.7 vs 0.9 years; p=0.002) and less morphological recurrence (p=0.02).

These findings suggest that early ileal resection may be more beneficial than harmful, being associated with reduced use of medical treatments and fewer morphological recurrences, according to researchers.