The outcome of excisional operations for primary and recurrent Crohn's disease of the large intestine
Goligher, J.C.
Surgery Gynecology and Obstetrics 148(1): 1-8
1979
ISSN/ISBN: 0039-6087 PMID: 758689 Document Number: 140520
During the years 1959-1977, surgical excision was performed upon 225 patients for primary Crohn's disease of the large intestine. In 48, it consisted of a total, subtotal or segmental colectomy with ileorectal, ileosigmoid or colocolonic anastomosis, with 3 instances of anastomotic leaks, one fatality and 27 recurrences. In 189, it took the form of a colorectal excision with ileostomy, or in 8, colostomy, with 15 operative deaths, 10 occurring in 34 patients who presented with acute exacerbations of the disease. Recurrent disease of the ileum, usually just proximal to the stoma, developed in 19 of 144 observed patients, 13.2%. It was no more likely to occur in patients who had had disease in the ileum at the time of the colectomy than in those who had not but was more frequent in patients less than 20 yr of age. Most significantly, the recurrence rate rose with an increase in the length of the follow-up period, being 43% in patients observed for at least 15 yr. Patients [79] with recurrent disease were treated at a 2nd resection and ileostomy after previous colectomy and ileostomy or ileorectal anastomosis, some of the recurrences having arisen in the group of 225 patients treated for primary disease, others being referred after primary operations done elsewhere. There were 3 operative deaths and 12 instances of a 2nd recurrence in 70 observed patients.