Short- and long-term outcomes of surgical treatment in patients with intestinal Behcet’s disease

Table 1 Patient characteristics and clinical variables

	Cases (n = 39)
Age (yr) at the time of diagnosis of BD, median (IQR)	36 (29-49)
Age (yr) at the time of diagnosis of intestinal BD, median (IQR)	38 (30-49)
Age (yr) at the time of surgery, median (IQR)	49 (31-57)
Interval (yr) between intestinal BD diagnosis and surgical treatment, median (IQR)	3 (1-8)
Sex, n (%)
Male	20 (51.3)
Female	19 (48.7)
Symptoms and signs of BD, n (%)
Oral ulcer	14 (35.9)
Genital ulcer	7 (18.0)
Ocular lesion	1 (2.6)
Skin lesion	0 (0.0)
Arthritis	0 (0.0)
Vascular lesion	1 (2.6)
Neurologic lesion	0 (0.0)
Location of ulceration, n (%)
Ileocecal	35 (89.7)
Ascending colon	3 (7.7)
Rectum	1 (2.6)
Medications, n (%)
Steroids	28 (71.8)
Colchicine	31 (79.5)
5-ASA or sulfasalazine	27 (69.2)
Azathioprine or 6-MP	23 (59.0)
TNF-α inhibitor	15 (38.5)
Antibiotics	13 (33.3)
Indication for operation, n (%)
Medical intractability	16 (41.0)
Perforation or fistula	16 (41.0)
Stricture	4 (10.3)
Bleeding	3 (7.7)
Preoperative CRP (mg/L), median (IQR)	3.9 (0.92-6.41)
Preoperative ESR (mm/h), median (IQR)	30.0 (15.0-49.5)
Preoperative neutrophil (%), median (IQR)	66.1 (59.0-73.8)
Preoperative lymphocyte (%), median (IQR)	18.1 (11.8-27.2)
Preoperative procalcitonin, median (IQR)	0.0 (0.0-0.1)
Preoperative albumin (g/dL), median (IQR)	3.0 (2.6-3.3)

BD: Behcet’s disease; IQR: Interquartile range; 5-ASA: 5-Aminosalicylic acid; 6-MP: 6-Mercaptopurine; TNF: Tumor necrosis factor; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate.

Table 2 Surgical data

	Cases (n = 39)
Emergency surgery, n (%)	5 (12.8)
Surgery type, n (%)
Open surgery	20 (51.3)
Laparoscopy	19 (48.7)
Surgical procedure, n (%)
SB segmental resection	3 (7.7)
Ileocecal resection	19 (48.7)
Right hemicolectomy	11 (28.2)
Other	6 (15.4)
Diverting stoma, n (%)	1 (2.6)
Expected blood loss, n (%)
Minimal	14 (35.9)
10-100 mL	16 (41.0)
> 100 mL	1 (2.6)
NA	8 (20.5)
Duration of surgery (min), median (IQR)	116 (95-740)

SB: Small bowel; IQR: Interquartile range; NA: Not assessed.

Table 3 Postoperative course and recurrence data

	Cases (n = 39)
Postoperative complications, n (%)
Anastomosis leakage	1 (2.6)
Intra-abdominal abscess	0 (0.0)
Fistula	0 (0.0)
Wound infection	3 (7.7)
Bleeding	1 (2.6)
Ileus	0 (0.0)
Mortality, n (%)	0 (0.0)
Clavien–Dindo classification, n (%)
1	2 (5.2)
2	0 (0.0)
3	3 (7.7)
4	0 (0.0)
Cause of reoperation, n (%)
Medical intractability	4 (50.0)
Perforation or fistula	4 (50.0)
Stricture	0 (0.0)
Bleeding	0 (0.0)
Reoperation procedure, n (%)
SB segmental resection	0 (0.0)
Redo anastomosis	7 (87.5)
Diverting stoma	1 (12.5)
Follow-up period (mo), median (IQR)	42.0 (8.0-72.0)
Time to recurrence (mo), median (IQR)	12.0 (6.25-17.75)

SB: Small bowel; IQR: Interquartile range.

Table 4 Risk factors for recurrence

	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Sex	0.358 (0.084-1.518)	0.163	2.372 (0.370-15.186)	0.362
Age at the time of surgery	0.979 (0.923-1.039)	0.487
Use of steroid	1.922 (0.386-9.566)	0.425
Use of colchicine	1.901 (0.232-15.552)	0.549
Use of azathioprine or 6-MP	0.919 (0.219-3.848)	0.908
Use of 5-ASA or sulfasalazine	1.195 (0.241-5.930)	0.828
Use of TNF-α inhibitor	1.485 (0.371-5.945)	0.577
Use of antibiotics	0.279 (0.034-2.267)	0.232
Preoperative CRP level	1.129 (1.031-1.236)	0.009	0.988 (0.868-1.125)	0.855
Preoperative ESR	1.001 (0.978-1.025)	0.925
Preoperative neutrophil	0.973 (0.080-1.172)	0.774
Preoperative lymphocyte	0.898 (0.650-1.240)	0.514
Preoperative procalcitonin	28.659 (0.290-2832.482)	0.152
Preoperative albumin level	0.336 (0.081-1.394)	0.133	0.220 (0.028-1.739)	0.151
Emergency surgery	12.216 (2.669-55.910)	0.001	10.746 (1.486-77.686)	0.019
Open surgery	1.423 (0.340-5.961)	0.629
Postoperative complication	2.051 (0.248-16.962)	0.505

5-ASA: 5-Aminosalicylic acid; 6-MP: 6-Mercaptopurine; TNF: Tumor necrosis factor; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; HR: Hazard ratio; CI: Confidence interval.