[Comparison of long-term course of perforating and non-perforating Crohn disease].
OBJECTIVE
To evaluate the influence of the indication of the first surgical procedure on the prognosis of Crohn's disease.


METHODS
We compared retrospectively the long-term course of 179 patients operated on for a perforating disease and 322 patients operated on for a nonperforating disease. Mean follow-up was 11 years and 2 months in the two groups.


RESULTS
Forty of 179 (25%) and 106 of 322 (33%) patients with perforating and nonperforating diseases underwent a second intestinal resection, respectively. The patients who had been operated on for a perforating disease were significantly more often reoperated on for the same indication, and conversely. Patients with perforating diseases experienced less second resections (actuarial rates: 37 +/- 11% vs 51 +/- 8% at ten years respectively), less post-surgical handicaps (mean index 24.9 vs 27.9), and fewer patients required immunosuppressive drugs (25 vs 35%).


CONCLUSIONS
Long-term prognosis of perforating Crohn's disease does not appear to be more severe than that of nonperforating disease.
Service d'Hépato-Gastroentérologie, Hôpital Rothschild, Paris.
J F
JF
Hamon
F
F
Carbonnel
L
L
Beaugerie
A
A
Sezeur
D
D
Gallot
M
M
Malafosse
R
R
Parc
J P
JP
Gendre
J
J
Cosnes
D000328:Adult; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery*; D008297:Male; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors
Comparaison de l'évolution à long terme des maladies de Crohn perforantes et non perforantes.