PATTERNS OF POSTOPERATIVE RECURRENCE IN FISTULIZING AND STENOTIC CROHNS-DISEASE - A RETROSPECTIVE COHORT STUDY OF 71 PATIENTS

To compare the time course of clinical recurrences and reoperations fo llowing primary resections for fistulization versus fibrostenotic obst ruction in ileal Crohn's disease, we performed a retrospective cohort study of 71 patients undergoing their first resection at The Mount Sin ai Hospital between 1961 and 1984. Among these 71 patients, 35 were cl assified as fistulizing and 36 as fibrostenotic. Follow-up was 93% com plete through 1990, with a median follow-up of 73 months to reoperatio n and 105 months to last contact. The fistulizing and fibrostenotic pa tients experienced virtually identical numbers of clinical recurrences : 25 from the former group and 24 from the latter. The recurrences app eared very slightly earlier among the fistulizing than among the fibro stenotic group, but the difference did not approach statistical signif icance. Only 18 patients came to reoperation during follow-up: 12 from the fistulizing and 6 from the fibrostenotic group. The earliest reop eration in the fistulizing group occurred at 14 months and in the fibr ostenotic group at 44 months. There was a trend for earlier reoperatio n in the fistulizing group, but the difference was not statistically s ignificant. Different clinical patterns of Crohn's disease have yet to be correlated with distinctive subclinical biologic markers.