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  • Title: Presence of granulomas is associated with recurrence after surgery for Crohn's disease: experience of a surgical unit.
    Author: Anseline PF, Wlodarczyk J, Murugasu R.
    Journal: Br J Surg; 1997 Jan; 84(1):78-82. PubMed ID: 9043461.
    Abstract:
    BACKGROUND: The determinants for recurrence of Crohn's disease remain controversial. Eight factors that might predict recurrence were studied in 130 patients operated on for Crohn's disease over a 24-year period. METHODS: Separate survival curves were estimated for each variable. A multivariate analysis was then carried out in which several selected explanatory variables were included simultaneously in a proportional hazards regression model. RESULTS: Operation for recurrent disease was necessary in 36 patients. Univariate analysis revealed a highly significant relationship between the presence of granulomas and subsequent recurrence (P = 0.003). There was a trend towards increased recurrence in patients with ileocolonic disease and segmental colectomy (P = 0.11 and P = 0.1 respectively). Age, sex, length of history, indication for operation and affected lines of transection were not associated with recurrence. After multivariate analysis, the association of granulomas with recurrence remained significant (P = 0.03). This association persisted when death was regarded as a treatment failure (P = 0.02). CONCLUSION: The presence of granulomas in patients with Crohn's disease is significantly associated with recurrence.
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