P0357 Comparing Surgical Outcomes Between Crohn’s disease and Gastrointestinal Behçet’s disease: A Single-Center Retrospective Cohort Study
Authors: Shin D H , Kang S , Kim J , Bae H W , Park M Y , Yang S Y , Han Y D , Hur H , Min B S , Cho M S 
Published: January 2025

Abstract

Background
Crohn’s disease (CD) and gastrointestinal Behçet’s disease (GIBD) are chronic inflammatory bowel disorders with similar presentations. Although they share treatment guidelines, empirical observations suggest worse postoperative outcomes in GIBD. This study compared long-term surgical outcomes between CD and GIBD patients undergoing primary bowel resection.

Methods
We conducted a retrospective cohort study of patients undergoing primary bowel resection for CD or GIBD at a single center (2001-2021). CD was confirmed by pathology, while GIBD was diagnosed using colonoscopic criteria and clinical manifestations. Clinical recurrence was defined as symptom recurrence with radiologic/endoscopic evidence. Surgical recurrence was defined as reoperation due to disease recurrence/progression.
Patient characteristics and outcomes were compared between CD (n=183) and GIBD (n=73) groups. Cumulative incidence functions analyzed recurrence rates. Propensity score matching (PSM) was performed to adjust for baseline differences, followed by survival analyses on the matched cohort.

Results
GIBD patients were significantly older at diagnosis (38.37 vs 25.06 years, p&lt;0.001) and operation (45.96 vs 30.12 years, p&lt;0.001), had longer disease duration (95.76 vs 62.80 months, p=0.005), higher BMI (21.27 vs 19.03, p&lt;0.001), and lower preoperative hemoglobin (10.29 vs 11.51 g/dL, p&lt;0.001). Postoperative hospital stay was longer in GIBD (19.93 vs 10.36 days, p=0.003).
Clinical recurrence rates were higher in GIBD (67.1% vs 48.1%, p=0.008), as were surgical recurrence rates (20.7% vs 8.7%, p&lt;0.001). Cumulative incidence analysis showed significantly higher recurrence rates in GIBD (Gray’s test, p&lt;0.001 for both recurrences).
After PSM (n=30 per group), GIBD patients had significantly lower clinical recurrence-free survival (HR 1.97, 95% CI 1.02-3.78, p=0.042) and showed a trend towards lower surgical recurrence-free survival (HR 3.62, 95% CI 0.98-13.41, p=0.054). Kaplan-Meier analysis confirmed lower recurrence-free survival in GIBD for both clinical and surgical recurrence (log-rank p=0.039 for both).

Conclusion
Despite similar postoperative complications, GIBD patients demonstrated significantly higher clinical and surgical recurrence rates after primary bowel resection. These findings persisted after PSM, particularly in time-to-event analyses, suggesting GIBD may have a more aggressive postoperative course than CD. Future prospective studies are warranted to develop tailored treatment guidelines for GIBD patients undergoing surgery.

References
Yazisiz V. Similarities and differences between Behçet’s disease andCrohn’s disease. World J Gastrointest Pathophysiol. 2014.15; 5(3): 228-238.
Baek SJ, Kim CH, Cho MS et al. Surgical Treatment and Outcomes in Patients WithIntestinal Behçet Disease: Long-term Experience ofa Single Large-Volume Center. Dis Colon Rectum 2015; 58: 575–581DOI: 10.1097
Zeng L, Meng WJ, Wen ZH et al. Management and outcomes of surgical patients with intestinalBehçet’s disease and Crohn’s disease in southwest China. World J Clin Cases. 2021; 9(16): 3858-3868.