Crohn's disease: a colon and rectal department experience.
This study reviewed a series of patients with Crohn's disease managed by surgeons of the Department of Colon and Rectal Surgery, St Vincent's Hospital, Melbourne, since 1978. There were 306 patients: 171 males and 135 females. The mean age at diagnosis was 33.4 years (ranger 11-93). The distribution of the disease was small bowel 32.3%, small bowel and colon 26.5%, colon 39.9%, and anal disease alone 1.6%. A total of 416 abdominal operations were performed on 204 patients. The commonest indications for surgery were failed medical therapy (21.9%), small bowel obstruction (15.9%), enteric fistula (10.1%), and intra-abdominal abscess (10.1%). The most frequently performed procedures were ileocolic resection with anastomosis (28.8%), small bowel resection (9.4%), and total colectomy and ileostomy (7.0%). Postoperative complications included anastomotic leaks in 4.0%, intra-abdominal abscess formation in 3.6%, and enterocutaneous fistulae developed in 6%. Three patients died during the review period. During follow up (mean 84.4), 30% of patients developed recurrence requiring further surgery at a mean of 72.7 months postoperatively. The most frequent site for a recurrence was the pre-anastomotic terminal ileum (61.7%). In conclusion, the majority of patients with Crohn's disease will require resectional surgery at some stage. This can be performed with a low mortality and morbidity, and a recurrence rate of around 5% per year.
Platell
C
C
Department of Colon and Rectal Surgery, St Vincent's Hospital, Fitzroy, Victoria, Australia.
Mackay
J
J
Collopy
B
B
Fink
R
R
Ryan
P
P
Woods
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002648:Child; D003082:Colectomy / Q000401:mortality; D003092:Colitis / Q000601:surgery; D003424:Crohn Disease / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007079:Ileitis / Q000601:surgery; D007081:Ileostomy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology; D011793:Queensland / Q000453:epidemiology; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies