Park MY, Yoon YS, Park JH, Lee JL, Yu CS. Short- and long-term outcomes of surgical treatment in patients with intestinal Behcet’s disease. World J Gastrointest Surg 2024; 16(2): 429-437 [PMID: 38463356 DOI: 10.4240/wjgs.v16.i2.429]
Corresponding Author of This Article
Yong Sik Yoon, MD, PhD, Professor, Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea. yoonys@amc.seoul.kr
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Feb 27, 2024; 16(2): 429-437 Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.429
Short- and long-term outcomes of surgical treatment in patients with intestinal Behcet’s disease
Min Young Park, Yong Sik Yoon, Jae Ha Park, Jong Lyul Lee, Chang Sik Yu
Min Young Park, Division of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul 03722, South Korea
Yong Sik Yoon, Jae Ha Park, Jong Lyul Lee, Chang Sik Yu, Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
Author contributions: Park MY designed and performed the research and wrote the paper; Yoon YS designed the research and supervised the report; Park JH collected the data; Lee JL and Yu CS provided clinical advice and supervised the report.
Institutional review board statement: The study protocol was approved by the institutional review board of Asan Medical Center (approval No. 2022-0238).
Informed consent statement: This study is retrospective study and use anonymous data, and Institutional Review Board of Asan Medical Center approved study and waived informed consent.
Conflict-of-interest statement: All authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong Sik Yoon, MD, PhD, Professor, Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea. yoonys@amc.seoul.kr
Received: October 17, 2023 Peer-review started: October 17, 2023 First decision: November 1, 2023 Revised: November 29, 2024 Accepted: January 15, 2024 Article in press: January 15, 2024 Published online: February 27, 2024
ARTICLE HIGHLIGHTS
Research background
Behcet's disease (BD) is a chronic vasculitic disorder that impacts various organs, presenting with recurring oral and genital ulcers, arthritis, vasculitis, and intestinal ulcers. Despite the frequent occurrence of intestinal complications in BD, the effectiveness and long-term results of surgical interventions for intestinal BD are yet to be definitively established.
Research motivation
Despite the frequent occurrence of intestinal complications in BD, the effectiveness and long-term results of surgical interventions for intestinal BD are yet to be definitively established.
Research objectives
To assess the postoperative clinical outcomes of intestinal BD and identify factors associated with its recurrence.
Research methods
A retrospective review of patients with intestinal Behcet's disease undergoing surgical resection at Asan Medical Center in Seoul, South Korea, between January 2010 and August 2021 was conducted. The study focused on patient demographics, clinical characteristics, surgical data, and postoperative outcomes, with the diagnosis of intestinal BD determined through a modified Delphi process, excluding patients with evidence of other gastrointestinal diseases during follow-up.
Research results
In a study involving 31 patients who underwent 39 surgeries for intestinal Behcet's disease, the mean patient age was 45.1 years, with a mean interval of 4.9 years between the diagnosis and surgical treatment. The primary indications for surgery were medical intractability (41.0%) and fistula or abscess (28.2%). Laparoscopic approaches were used in 48.7% of cases, and eight recurrences (20.5%) requiring reoperation were observed during a mean follow-up of 45 months, with a recurrence rate of 10.3% at 1 year and 20.5% at 3 years. Emergency surgery and elevated C-reactive protein levels were identified as predictors of recurrence in multivariate analysis.
Research conclusions
Surgical resection is a viable treatment for complicated BD, despite its association with challenging clinical courses and elevated reoperation rates, emphasizing the importance of timely surgical intervention to mitigate reoperation risk, particularly in the presence of severe inflammatory conditions.
Research perspectives
It is necessary to identify factors, including specific biomarkers, that may influence recurrence through a larger number of patients with intestinal BD and make efforts to reduce recurrence rates using this information.
