Postoperative Recurrence in Crohnʼs Disease

Abstract

The surgical experience of 61 patients with Crohn''s disease who have received surgical treatment over a 32-yr period was reviewed. Sex, age at onset of symptoms, associated systemic abnormalities, presenting symptoms, indication for previous surgery and site of disease were not significant predictors of postoperative recurrence. Certain extensive resections of the small bowel are associated with a decreased probability of rehospitalization and reoperation. Resection of > 25 cm of the small bowel and > 50 cm of the total (small plus large) bowel was associated with a decreased likelihood of recurrence. Interestingly, analysis of larger resections (50, 75, 100 cm) failed to document a decreased likelihood of recurrence. The amount of large bowel resected did not predict postoperative recurrence. Bypass and diversion procedures offer a significantly enhanced risk for recurrent disease, whereas procedures employing resection are associated with lower probabilities of recurrent disease. Technically, adequate resections of 25-50 cm of the small bowel or the combined small and large bowel and associated with a decreased probability of reoperation or rehospitalization after the initial surgery for Crohn''s disease.