Indications for surgery in intestinal Behçet's disease.
OBJECTIVE
As advances in steroids and immunosuppressants made medical treatment first-line therapy for Behçet's disease, the criteria for elective surgery became unclear. The aim of this paper is to establish surgical criteria for Behçet's.


METHODS
We reviewed the medical records of 8 consecutive Japanese patients who were diagnosed with intestinal Behçet's at Tsukuba University Hospital between 1976 and 2001. Records were examined for medical treatment including dose of steroids, and surgical treatment including length of resected intestine, incidence of recurrence, and the form and site of recurrence.


RESULTS
Elective surgery was performed in cases where the preoperative steroid administration could not be reduced to under 40mg/day, once steroids exceeded 40mg/day to control symptoms and inflammation. Cases with emergency operations (perforated cases), the preoperative doses of steroids were not so high (0, 0, 10, 20mg/day). In all cases, the post-surgical steroid dose was reduced under 20mg/day. Three cases showed recurrence after surgery within 2 years. These cases also had an increase in steroid dosage at the time of recurrence, but have been controlled medically so far.


CONCLUSIONS
Surgery should be strongly considered when the steroid dose exceeds 40mg/day.
Kurata
Masanao
M
Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Nozue
Mutsumi
M
Seino
Ken-ichiro
K
Murata
Hideyuki
H
Sumita
Takayuki
T
Katashi
Fukao
F
D000293:Adolescent; D000328:Adult; D001528:Behcet Syndrome / Q000188:drug therapy / Q000601:surgery*; D002648:Child; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007410:Intestinal Diseases / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage
D005938:Glucocorticoids; D011239:Prednisolone