SURGICAL RESULTS FOR CROHN'S DISEASE

• Published in: Journal of The Showa Medical Association Vol. 59; no. 4; pp. 468 - 474
• Main Authors: SHIBUSAWA, Miki, TSUNODA, Akira, YAMAZAKI, Katsuo, HIRATSUKA, Kenshi, KAMIYAMA, Gouichi, TAKATA, Manabu, YOKOYAMA, Noboru, YOSHIZAWA, Hiroto, NAKAO, Kentaro, CHO, Hirotoshi, YASUDA, Naokuni, KUSANO, Mitsuo
• Format: Journal Article
• Language: Japanese
• Published: The Showa University Society 1999
• Subjects: Crohn's disease; recurrence and reoperation after initial operation; surgical results in Crohn's disease
• ISSN: 0037-4342; 2185-0976
• DOI: 10.14930/jsma1939.59.468

Twenty-four patients with Crohn's disease who underwent resectional surgery at Showa University Hospital and other allied hospitals, over a recent 21-year period were analyzed to evaluate the surgical results and postoperative courses. The average onset age was 34 years old and the ailing time from the onset to the operation was 3 years. Eleven patients (45.8%) had ileocolonic disease and three of them underwent surgery because of enterovesical fistula. Another three patients had bowel stricture. Eight patients (33.3%) had ileal disease and four of them were operated on for bowel stricture. Postoperative recurrence occurred in ten patients (41.6%) ; seven of those patients were indicated for reoperation. Five of the seven reoperated patients had ileocolonic disease and intestinal stricture, and this was the reason for their reoperations. The cumulative reoperation rates were 21% at 5 years and 29% at 10 years after the initial operation. The risk of reoperation tended to increase in proportion, as the onset age began younger. The follow up periods ranged from 6 months to 21 years (average 9.1 years) ; two patients died. It is important to determine proper operative indication and appropriate operative procedures and also to improve surgical therapy combined with dietry controls and chemotherapy.