Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejada / Outcome of surgery for Crohn's colitis: review of 28 cases
Rev. méd. Chile
;
146(2): 183-189, feb. 2018. tab
Article
Dans Espagnol
| LILACS
| ID: biblio-961376
ABSTRACT
Background:
Exclusive involvement of the colon or rectum in Crohn's disease, called Crohn's colitis, (CC) occurs in about 25% of these patients.Aim:
To analyze early surgical results and long-term outcomes of patients undergoing surgery for CC. Material andMethods:
Review of a prospective database, identifying patients with Crohn's disease operated between 2003 and 2015 and excluding those with ileocecal disease. We analyzed demographic data, pre and postoperative pharmacological treatment, operations, morbidity and the need for a second bowel resection at follow-up.Results:
We reviewed data from 28 patients aged 17 to 72 years (15 men). Twenty-seven (96.4%) had previous pharmacological treatment, 11 received monoclonal antibodies. The most common indications for surgical treatment were failure of medical treatment in 15 cases, acute severe colitis in 12 and anemia/malnutrition in eight. Total colectomy was performed in 17 (61%) patients, proctocolectomy in 8 (29%) and segmental colectomies in 3 (11%). Sixteen (57%) were operated laparoscopically. Major postoperative complications were observed in 5 (18%). Four needed a reintervention. There was no operative mortality. During a 55 months median follow-up of 27 patients, seven (26%) required a second bowel resection, one of them for recurrence. Nineteen (70%) patients had an ostomy, which was permanent in 11. Fifteen patients are without medical treatment.Conclusions:
Most of the reviewed patients required total colectomy for the control of the disease with a low surgical morbidity. Two-thirds required an ileostomy, which became permanent in half of them.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Maladie de Crohn
Type d'étude:
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Adolescent
/
Adulte
/
Adulte très âgé
/
Femelle
/
Humains
/
Mâle
langue:
Espagnol
Texte intégral:
Rev. méd. Chile
Thème du journal:
Médicament
Année:
2018
Type:
Article
Pays d'affiliation:
Chili
Institution/Pays d'affiliation:
Pontificia Universidad Católica de Chile/CL
Documents relatifs à ce sujet
MEDLINE
...
LILACS
LIS