[Surgical treatment of Crohn's disease of the large intestine: do rectal complications influence the results of ileorectal anastomosis?].
OBJECTIVE
The purpose of this retrospective study was to compare the morbidity and long-term outcome of patients undergoing total colectomy and ileorectal anastomosis (IRA) performed for Crohn's colitis with or without associated proctitis.


METHODS
Thirty-nine patients with a mean age of 35 years (17-72 years) underwent total colectomy with IRA. Patients were retrospectively classified into two groups; group 1 (28) without rectal involvement; group 2 (11) with proctitis. Follow-up data were obtained during 1998, by reviewing all patients. Mean postoperative follow-up was 10.6 years (1.5-22).


RESULTS
There were no postoperative deaths. Six (15%) patients experienced postoperative complications, with no difference between the two groups. Sixteen patients (41%) developed recurrence requiring surgery: 9 in group 1 (32%) and 7 in group 2 (64%) (p > 0.05). The IRA had to be removed or was no longer functional in 12 patients: 6 in group 1 (21.5%) and 6 in group 2 (54.5%) (p < 0.05).


CONCLUSIONS
Moderate proctitis does not increase the morbidity of total colectomy with IRA for Crohn's disease. The risk of reoperation and secondary protectomy is higher when proctitis was present, but the IRA was still functional in one-half of patients after more than 10 years of follow-up.
Martel
P
P
Service de chirurgie digestive, hôpital Bichat, Paris, France.
Betton
P O
PO
Gallot
D
D
Sezeur
A
A
Malafosse
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D003082:Colectomy; D003424:Crohn Disease / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011349:Proctitis / Q000601:surgery*; D012007:Rectum / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies