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Temporal trends in surgery for Crohn’s disease: a ten-year single-center retrospective study

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Abstract

Purpose

Crohn’s disease (CD) is a chronic inflammatory bowel disease that requires surgery in many cases. The aim of this article is to present the experience of a referral center regarding surgical interventions for CD, while also exploring the transformations that have occurred over 10 years.

Methods

The data of patients underwent abdominal surgery for CD between 2013 and 2022 were collected prospectively. Data were compared between two periods (2013–2017 and 2018–2022). Temporal trends were assessed with the Mann–Kendall trend test.

Results

A total of 1059 individuals underwent 1176 surgical procedures, of which 67.1% were male. The median age of patients at the time of surgery was 36.0 years, and an overall increasing trend was observed in surgical volume (z = 3.04; p = 0.002). The proportion of patients treated with biologics increased from the first period (2013–2017) to the second (2018–2022), rising from 19.2% to 33.5% (p < 0.001). In the second stage, the proportion of patients who underwent surgery for abscesses or fistulas increased (47.8% vs. 40.0%, p = 0.028), while the percentage of emergency surgeries declined (3.0% vs. 7.1%, p = 0.001). Furthermore, there was a rise in the proportion of laparoscopic surgeries (76.5% vs. 63.7%, p < 0.001), coupled with a decrease in stoma rates (15.4% vs. 30.5%, p < 0.001) and postoperative complications (23.0% vs. 30.5%, p = 0.007).

Conclusion

The frequency of biologics use in CD surgery have increased over time, and the proportion of penetrating patients has grown. Minimally invasive surgical methods have become the norm, and surgical outcomes have markedly enhanced, evidenced by a substantial reduction in both stoma rates and complication rates.

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Data availability

Data supporting the findings of this study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China

    Wei Liu, Xiaolong Ge, Zhaoqi Shi, Weilin Qi, Ziyao Wei, Liping Cao & Wei Zhou

  2. Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China

    Qian Cao

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  1. Wei Liu
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Contributions

Wei Liu and Wei Zhou developed the study concept and design. Xiaolong Ge, Weilin Qi, Zhaoqi Shi, Ziyao Wei and Qian Cao collected and analyzed the data. Wei Liu, Liping Cao and Wei Zhou wrote the manuscript. All authors reviewed the manuscript.

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Correspondence to Wei Zhou.

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Liu, W., Ge, X., Shi, Z. et al. Temporal trends in surgery for Crohn’s disease: a ten-year single-center retrospective study. Int J Colorectal Dis 38, 221 (2023). https://doi.org/10.1007/s00384-023-04514-6

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