Crohn's disease in a defined population course and results of surgical treatment. Part II. Large bowel disease.
In a total consecutive series of 182 patients operated upon for Crohn's disease, 95 (52%) had the lesions predominantly or exclusively confined to the colon. A "radical" operation was performed in 88 of these 95 patients. The general policy was to spare the rectum, if possible. It was found that when the rectum was primarily involved the lesions did not disappear after subtotal colectomy. Ileorectal anastomosis was only successful in 9 of 22 cases. In all these nine cases the rectum was uninvolved preoperatively. The overall mortality rate related to Crohn's disease was 6% and the overall recurrence rate 62%. All patients with an anastomosis between a disease-free small intestine and a diseased colon developed recurrence in the ileum. Therefore, a thorough preoperative examination of the whole colon is essential.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003082:Colectomy; D003424:Crohn Disease / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy; D007420:Intestine, Large / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011788:Quality of Life; D012007:Rectum / Q000473:pathology; D012008:Recurrence