Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 17, Number 2, April 2024, pages 64-71

Predictive Factors of Non-Inflammatory Small Bowel Obstruction After Bowel Resection in Crohn’s Patients

**Table 1.** Baseline Characteristics of the Study Population
5-ASA: 5-aminosalicylic acids; SD: standard deviation; IQR: interquartile range.
Baseline characteristics
Age at the time of surgery, years, mean (SD)	33 (16)
End-to-end anastomosis, n (%)	324 (96.7)
Surgery performed through laparoscopy, n (%)	266 (79)
Median number of life-long bowel resections, median (IQR)	1 (1 - 2)
Receiving a biologic post-surgery, n (%)	274 (81.6)
Receiving combination (biologic and immunomodulator) therapy post-surgery, n (%)	171 (51.4)
Receiving 5-ASA post-surgery, n (%)	8 (2.4)
Received a course of metronidazole post-surgery, n (%)	91 (27)
Active smoker at the time of surgery, n (%)	104 (31.5)
Active inflammation in the surgical specimen, n (%)	327 (98.5)
Stricture at the time of surgery, n (%)	300 (90)
Length of bowel resected, cm, mean (SD)	23 (17)
Post-operative complication, n (%)	54 (16)
Active Crohn’s disease other than the surgical specimen	35 (10.5)
Body mass, kg, mean (SD)	78 (21)
Active smoker, n (%)	104 (31)
Crohn’s disease phenotype
Stricturing disease, n (%)	331 (98.5)
Presence of fistulas, n (%)	157 (47)
Perianal disease, n (%)	91 (27.3)

Table 1. Baseline Characteristics of the Study Population

5-ASA: 5-aminosalicylic acids; SD: standard deviation; IQR: interquartile range.

Baseline characteristics

Age at the time of surgery, years, mean (SD)

33 (16)

End-to-end anastomosis, n (%)

324 (96.7)

Surgery performed through laparoscopy, n (%)

266 (79)

Median number of life-long bowel resections, median (IQR)

1 (1 - 2)

Receiving a biologic post-surgery, n (%)

274 (81.6)

Receiving combination (biologic and immunomodulator) therapy post-surgery, n (%)

171 (51.4)

Receiving 5-ASA post-surgery, n (%)

8 (2.4)

Received a course of metronidazole post-surgery, n (%)

91 (27)

Active smoker at the time of surgery, n (%)

104 (31.5)

Active inflammation in the surgical specimen, n (%)

327 (98.5)

Stricture at the time of surgery, n (%)

300 (90)

Length of bowel resected, cm, mean (SD)

23 (17)

Post-operative complication, n (%)

54 (16)

Active Crohn’s disease other than the surgical specimen

35 (10.5)

Body mass, kg, mean (SD)

78 (21)

Active smoker, n (%)

104 (31)

Crohn’s disease phenotype

Stricturing disease, n (%)

331 (98.5)

Presence of fistulas, n (%)

157 (47)

Perianal disease, n (%)

91 (27.3)

**Table 2.** Differences in Baseline Variables Between Patients Who Had NI-SBO Within 5 Years of Ileal Resection vs. Those Without
	NI-SBO within 5 years	No NI-SBO within 5 years	P-value
*Statistically significant. CD: Crohn’s disease; IQR: interquartile range; NI-SBO: non-inflammatory small bowel obstruction; SD: standard deviation.
Rutgeerts score at post-resection colonoscopy, median (IQR)	1 (0 - 2)	0 (0 - 2)	0.12
Total number of bowel resections, median (IQR)	2 (2 - 3)	1 (1 - 2)	0.0002*
Body mass, kg, mean (SD)	74 (21)	78 (21)	0.29
Length of resected bowel, cm, median (IQR)	18 (12 - 28)	17 (12 - 29)	0.79
History of perianal CD, n (%)	6 (21)	83 (28.2)	0.39
Active smoker, n (%)	9 (31)	92 (31.1)	0.95
Age at the time of surgery, years, mean (SD)	38 (18)	33 (16)	0.16
Complete SBO at the time of surgery, n (%)	25 (86.2)	266 (89.6)	0.58
Active inflammation in the surgical specimen, n (%)	28 (96.6)	289 (98.6)	0.39
Active inflammation in the surgical margins, n (%)	13 (56.5)	65 (27)	0.004*
Post-operative complication (30-day) at the time of surgery, n (%)	8 (28)	43 (14.5)	0.064
Active CD in an area other than the resected bowel, n (%)	4 (13.8)	31 (10.5)	0.58
Index surgery performed through laparoscopy (vs. open), n (%)	17 (58.6)	247 (80.5)	0.006*

Table 2. Differences in Baseline Variables Between Patients Who Had NI-SBO Within 5 Years of Ileal Resection vs. Those Without

NI-SBO within 5 years

No NI-SBO within 5 years

P-value

*Statistically significant. CD: Crohn’s disease; IQR: interquartile range; NI-SBO: non-inflammatory small bowel obstruction; SD: standard deviation.

Rutgeerts score at post-resection colonoscopy, median (IQR)

1 (0 - 2)

0 (0 - 2)

0.12

Total number of bowel resections, median (IQR)

2 (2 - 3)

1 (1 - 2)

0.0002*

Body mass, kg, mean (SD)

74 (21)

78 (21)

0.29

Length of resected bowel, cm, median (IQR)

18 (12 - 28)

17 (12 - 29)

0.79

History of perianal CD, n (%)

6 (21)

83 (28.2)

0.39

Active smoker, n (%)

9 (31)

92 (31.1)

0.95

Age at the time of surgery, years, mean (SD)

38 (18)

33 (16)

0.16

Complete SBO at the time of surgery, n (%)

25 (86.2)

266 (89.6)

0.58

Active inflammation in the surgical specimen, n (%)

28 (96.6)

289 (98.6)

0.39

Active inflammation in the surgical margins, n (%)

13 (56.5)

65 (27)

0.004*

Post-operative complication (30-day) at the time of surgery, n (%)

8 (28)

43 (14.5)

0.064

Active CD in an area other than the resected bowel, n (%)

4 (13.8)

31 (10.5)

0.58

Index surgery performed through laparoscopy (vs. open), n (%)

17 (58.6)

247 (80.5)

0.006*

**Table 3.** Univariate Analysis Showing Variables Associated With the Development of a Non-Inflammatory Small Bowel Obstruction Within 5 Years or Ileocolonic Resections
Variable	OR	95% CI	P-value
*Statistically significant. CI: confidence interval; OR: odds ratio.
Female gender	1.1	0.51 - 2.34	0.83
Age > 40 years	1.7	0.76 - 3.6	0.2
On biologic therapy after the index surgery	1.1	0.39 - 2.92	0.9
Active inflammation in the surgical margins (index surgery)	3.4	1.44 - 8.23	0.004*
Active Crohn’s disease in areas other than the resected bowel (index surgery)	1.4	0.5 - 4.3	0.55
Bowel stricture at the time of index surgery	1.0	0.29 - 3.53	0.99
History of bowel resection previous to the index surgery	5.1	2.03 - 13.0	0.0002*
Development of a complication after index surgery	2.2	0.9 - 5.2	0.1
Rutgeerts score > i1 on surveillance colonoscopy after index surgery	1.5	0.63 - 3.4	0.38
Active smoker	1.0	0.44 - 2.3	0.99
Index surgery performed through open laparotomy (versus laparoscopy)	2.9	1.3 - 6.4	0.01*

Table 3. Univariate Analysis Showing Variables Associated With the Development of a Non-Inflammatory Small Bowel Obstruction Within 5 Years or Ileocolonic Resections

Variable

95% CI

P-value

*Statistically significant. CI: confidence interval; OR: odds ratio.

Female gender

1.1

0.51 - 2.34

0.83

Age > 40 years

1.7

0.76 - 3.6

0.2

On biologic therapy after the index surgery

1.1

0.39 - 2.92

0.9

Active inflammation in the surgical margins (index surgery)

3.4

1.44 - 8.23

0.004*

Active Crohn’s disease in areas other than the resected bowel (index surgery)

1.4

0.5 - 4.3

0.55

Bowel stricture at the time of index surgery

1.0

0.29 - 3.53

0.99

History of bowel resection previous to the index surgery

5.1

2.03 - 13.0

0.0002*

Development of a complication after index surgery

2.2

0.9 - 5.2

0.1

Rutgeerts score > i1 on surveillance colonoscopy after index surgery

1.5

0.63 - 3.4

0.38

Active smoker

1.0

0.44 - 2.3

0.99

Index surgery performed through open laparotomy (versus laparoscopy)

2.9

1.3 - 6.4

0.01*

**Table 4.** Multivariable Analysis Showing Variables Independently Associated With the Development of a Non-Inflammatory Small Bowel Obstruction Within 5 Years or Ileocolonic Resections
Variable	aOR	95% CI	P-value
*Statistically significant. aOR: adjusted odds ratio; CI: confidence interval.
Female gender	1.0	0.3 - 3.3	0.94
Age > 40 years	0.7	0.2 - 2.1	0.51
On biologic therapy after the index surgery	2.2	0.4 - 12.8	0.37
Active inflammation in the surgical margins (index surgery)	5.0	1.7 - 14.8	0.003*
Active Crohn’s disease in areas other than the resected bowel (index surgery)	1.7	0.4 - 6.8	0.43
Bowel stricture at the time of index surgery	0.8	0.1 - 4.6	0.76
History of bowel resection previous to the index surgery	4.8	1.4 - 16.8	0.015*
Development of a complication after index surgery	1.6	0.4 - 6.5	0.54
Rutgeerts score > i1 on surveillance colonoscopy after index surgery	1.5	0.5 - 4.4	0.51
Active smoker	0.8	0.2 - 2.7	0.73
Index surgery performed through open laparotomy (versus laparoscopy)	6.1	1.9 - 19.7	0.002*

Table 4. Multivariable Analysis Showing Variables Independently Associated With the Development of a Non-Inflammatory Small Bowel Obstruction Within 5 Years or Ileocolonic Resections

Variable

aOR

95% CI

P-value

*Statistically significant. aOR: adjusted odds ratio; CI: confidence interval.

Female gender

1.0

0.3 - 3.3

0.94

Age > 40 years

0.7

0.2 - 2.1

0.51

On biologic therapy after the index surgery

2.2

0.4 - 12.8

0.37

Active inflammation in the surgical margins (index surgery)

5.0

1.7 - 14.8

0.003*

Active Crohn’s disease in areas other than the resected bowel (index surgery)

1.7

0.4 - 6.8

0.43

Bowel stricture at the time of index surgery

0.8

0.1 - 4.6

0.76

History of bowel resection previous to the index surgery

4.8

1.4 - 16.8

0.015*

Development of a complication after index surgery

1.6

0.4 - 6.5

0.54

Rutgeerts score > i1 on surveillance colonoscopy after index surgery

1.5

0.5 - 4.4

0.51

Active smoker

0.8

0.2 - 2.7

0.73

Index surgery performed through open laparotomy (versus laparoscopy)

6.1

1.9 - 19.7

0.002*