POSTOPERATIVE LONG-TERM COURSE OF CROHN'S DISEASE

Abstract

Twenty-two patients with Crohn's disease who were operated at our hospital and followed-up for more than 5 years were clinicopathologically studied. Involved portion of intestinal tract were 10 in small bowel, 12 in small and large bowel and one in colon. Major indication for surgery are as follow ; stenosis, fistula formation, perforation peritonitis and intractability of medical treatment. In 17 cases, the lesions were resected completely, but recurrence was found in 7 cases (small bowel type 5, small and large bowel type 2). Mean intervals of recurrence in small bowel cases were 8 months. Initial recurrences were found at the suture line, and did not show wide spreading in subsequent periods. Two patients were required the excision of the recurrent lesions because of remarkable stenosis 5 years 6 months and 9 years 8 months after surgery, respectively. Five cases of small and large bowel types were remained lesions of resected intestinal margin at the time of resection. The remained suture line lesions were unchanged for a long period. Multiple aphthoid ulcers and small ulcers disappeared by medical treatment. Three of these were almost good condition as for the quality of life after surgery. However, two cases residued skip lesions of sigmoid colon were not so good condition because of intractability of medical treatment. Medical treatment for recurrence or surgically remained lesions of Crohn's disease were effective.