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

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.