Risk factors for endoscopic postoperative recurrence in patients with Crohn’s Disease: a protocol for systematic review and meta-analysis

Abstract Background Crohn’s disease (CD) is a chronic condition characterized by a high recurrence rate after surgery, which seriously affects the quality of life of patients. Many studies have explored the risk factors for the recurrence of CD after surgery, there is a lack of meta-analysis focusing on endoscopic postoperative recurrence (ePOR) as a clinical outcome. Therefore, this paper aims to identify the risk factors for ePOR in CD patients through systematic review and meta-analysis. Methods PubMed, Embase, Cochrane Library, and Web of Science databases were searched for related literature from inception to 17th October 2023. Two researchers independently screened the literature and extracted information. Data analysis was performed using Stata18.0. Results Twenty-three papers were included, with 5 case-control studies and 18 cohort studies. The National Institutes of Health quality assessment tool rated 17 studies as good and 6 studies as fair. The sample size of the 23 studies ranged from 40 to 346, and the number of patients with ePOR ranged from 23 to 169. The results of multivariate meta-analysis showed that smoking OR = 2.06, 95% CI (1.65, 2.57), P = 0.0001, previous ileocolonic resection OR = 1.71, 95% CI (1.23, 2.38), P = 0.002, disease localization at ileocolic resection OR = 2.68, 95% CI (1.38, 5.22), P = 0.004, perianal disease OR = 1.47, 95% CI (1.07, 2.03), P = 0.017, and anastomotic scattered ulcer OR = 3.39, 95% CI (1.83, 6.28), P = 0.001 were risk factors for ePOR in CD patients. Postoperative prophylactic medication OR = 0.53, 95% CI (0.38,0.75), P = 0.0001 was a protective factor for ePOR in CD patients. Conclusions This systematic review identified multiple factors for ePOR in CD patients, as well as a protective factor. However, the number of articles included was limited. More high-quality clinical studies are required to further validate the conclusions. Trial registration This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023483671).