title: Indications for surgery in intestinal Behçet's disease.
abstract: 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.
authors.affiliation: Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
authors.forename: Masanao
authors.initials: M
authors.lastname: Kurata
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Nozue
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Seino
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Murata
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sumita
authors.forename: Fukao
authors.initials: F
authors.lastname: Katashi
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone