Results of Surgical Treatment of Crohn`s Disease

ABSTRACT

We have performed a retrospective analysis of 42 patients with Crohn's disease operated at the Department of Surgery, Seoul National University College of Medicine between 1978 and 1997. The most frequently involved site was ileocecum(40.5%) and small bowel(40.5%), whereas the large bowel and anorectum occupied only 2.4% and 7.1% rutspectively. In 39 patients with bowel involvement, 35 patients(90%) required resection as primary surgical operations(small bowel 18, right colon 11, ileocecum 6). The remaining 7 patients underwent intaabdominal abscess drainage(2), perianal abscess drainage(2), appendectomy(1), and exploration only(1). Two cases of small bowel resection were combined with multiple stricturoplasties. After mean follow-up period of 46 months(range 1~180, median 22 months) after primary operation, the cumulative reoperative recurrence rate was 25% at 3 years,47% at 5 years, and 79% at 10 years, respectively. The ileocecal type had higher cumulative reoperative recurrence rate than small bowel type(50% compared to 34% at 5 years). The age at symptom onset, age at time of first operation, duration between symptom onset and operation, and the indication for operation had no effect on reoperative recurrence rate. Despite short follow-up period and limited number of patients, our results confirmed that Crohn's disease is associated with high rate of recurrence requiring re-operations.