[Surgery of Crohn's disease: a study of 155 patients after intestinal resection (author's transl)].
Operative mortality after intestinal resection in 155 patients with Crohn's disease was 8.4%. In 12 of 13 the cause of death was septic complications, most of them related to prolonged pre-operative cortisone medication. Follow-up examination was possible in 90% of all discharges. Five-year recurrence rate was 37.6%. Recurrence was not prevented by long-term drug treatment. Purely macroscopic assessment of the resection margins would have led to excision within diseased gut: for this reason frozen sections are recommended before the anastomosis is made. Primary death-rate in 30 cases of colectomy with primary ileorectostomy was 3%. In three patients the rectum had to be excised, while in one the anastomosis had to be taken down because of recurrence. The failure rate was thus only 11%. If rectoscopy, stepwise biopsy and intra-operative frozen section indicate a normal rectum it is recommended that ileorectostomy be done rather than diversion ileostomy with occlusion of the rectum or even proctocolectomy.
D003082:Colectomy / Q000401:mortality; D003424:Crohn Disease / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D005860:Germany, West; D006801:Humans; D007081:Ileostomy; D011183:Postoperative Complications; D012008:Recurrence; D018805:Sepsis / Q000209:etiology; D013997:Time Factors
Die Chirurgie des Morbus Crohn. Klinische Studie an 155 Patienten mit Darmresektionen.