Postoperative outcome of Crohn's disease in 30 children.
BACKGROUND
Thirty children operated on for Crohn's disease (CD) were reviewed (1975-1994). The aim of the study was to assess their postoperative outcome.


METHODS
19 boys and 11 girls, aged 15.3 (2) years (range 11.3-20) at surgery were studied.


RESULTS
Surgical indications were acute complications of CD and chronic intestinal illness. Six months after surgery, 11 of 12 patients had been weaned off steroids, and 22 of 23 patients were weaned off nutritional support; 17 patients without recurrence had a mean (SD) weight gain of 2.1 (8) kg and a height gain of 3.36 (3) cm. During 3.1 (2.7) years follow up, 12 patients (40%) had a recurrence of the disease after 19.4 (14) months (means (SD)): supra-anastomotic recurrence (six), severe perianal disease (two), and chronic illness (four). Six of 14 patients who were treated with mesalazine (13) or azathioprine (one) had recurrences. The postoperative recurrence rate was 50% at two years.


CONCLUSIONS
Surgical treatment modifies the immediate outcome of severe or complicated CD, but does not prevent recurrence, despite localised resection or prophylactic postoperative treatment. Extension of the disease before surgery seems to be a major risk factor for postoperative recurrence in children.
Besnard
M
M
Paediatric Gastroenterology Department, Hôpital Robert Debré, 48 Boulevard Sérurier, 75019 Paris, France.
Jaby
O
O
Mougenot
J F
JF
Ferkdadji
L
L
Debrun
A
A
Faure
C
C
Delagausie
P
P
Peuchmaur
M
M
Aigrain
Y
Y
Navarro
J
J
Cézard
J P
JP
D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D002648:Child; D003424:Crohn Disease / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D011182:Postoperative Care; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine; D001379:Azathioprine