Results in the radical surgical treatment of Crohn's disease.

ABSTRACT

A series of 60 patients were operated on, in our hospital, for Crohn's disease over a ten-year period. Three main groups of patients were distinguished according to the kind of intestinal involvement at surgery; those with the classical disease (involvement of the terminal ileum), those with Crohn's ileocolitis and those with Crohn's colitis. Operations, in which all the affected bowel with a free margin of at least 15 cm on each side of the lesions was resected, were considered "radical" surgical procedures. All patients who underwent surgery for the classical disease were treated radically and 54.4% of those affected with Crohn's ileocolitis underwent radical surgery. From our data early surgery seems to have an important effect upon radicality. In the follow-up study, mortality, percentage recurrence, quality of life and biochemical findings were separately assessed and evaluated for each group of subjects. Only radically operated subjects were evaluated for recurrence. The percentage recurrence was 12.9% in the classical disease group (mean postoperative follow-up time 44.2 months), 27.3% in Crohn's ileocolitis group (mean follow-up time 21.1 months), 0% in Crohn's colitis group (mean follow-up time 61.5 months). Over-all operative mortality was 0%.