Recurrence Rate after Surgical Treatment of Crohn's Disease

Abstract

In an unselected series of 207 consecutive patients with Crohn's disease diagnosed between 1958 and 1974, 170 underwent a resection of all the macroscopically involved bowel ('radically' resected). Two patients died during the first postoperative month. The crude recurrence rate for the surviving 168 patients was 49%. The cumulative recurrence rate, calculated by the actuarial method, was 53% at 15 years. Age, sex, length of preoperative disease history, localization of the lesions in the bowel, and primary surgical procedures performed had no influence on the recurrence rate. However, the histopathological appearance of the resection margins seemed to influence the prognosis, since the presence of ulcers and/or granulomas was correlated with a significantly increased recurrence rate.

Crohn’s disease patients with chronic intestinal failure receiving long-term parenteral nutrition: a cross-national adult study

“…CIF incidence did not decrease over time (1.4 ⁄ year before 1995 vs. 2.2 ⁄ year after). Median number of small bowel resections per patient was three (range [1][2][3][4][5][6][7][8]. Median small bowel resection, remnant and initial lengths were 160, 80 and 260 cm, respectively.…”

“…[1][2][3][4][5] Recurrence rate after surgery highly fluctuated from 11 to 32% at 5 years, and from 20 to 44% at 10 years. [6][7][8][9][10] In spite of multiple small bowel (SB) resections in a large number of patients, the occurrence of chronic intestinal failure (CIF) is an extremely rare event during CD. Incidence of CIF complicating CD may be indirectly evaluated based on the data of home parenteral nutrition registries, since in the most severe CIF cases, patients require HPN for a long time or even indefinitely.…”

Surgical Management of Crohn’s Disease: How Much to Resect?

“…[1] only recurrent disease requiring further 5,13,21], the incidence of recurrent disease is still high, which leads to short-bowel syndrome in these patients. More over, the increased length of bowel resection has been reported as predisposing to postoperative complications [9], On the other hand, at the present time Crohn's dis ease may be considered as having simultaneous multifo cal involvement [4,7], Therefore any effort at definitely obtaining disease-free tissue near the specimen would seem illusory.…”

“…Evidence has been reported in the literature that bypass procedures enhance the recurrence rate [5,13]. Nowadays controversy still arises over how much bowel has to be resected.…”

Postoperative Recurrence of Crohn’s Disease in Relation to Radicality of Operation and Sulfasalazine Prophylaxis: A Multicenter Trial

“…Resection does not cure the disease and the rate of recurrence is high [8,9,18,20], Early recurrence is common and could be demonstrated within 1 year postoperatively in 70% of patients progressing from early and limited inflammatory lesions…”