POSTOPERATIVE OUTCOME OF CROHNS-DISEASE IN 30 CHILDREN

Background-Thirty children operated on for Crohn's disease (CD) were r eviewed (1975-1994). The aim of the study was to assess their postoper ative outcome. Patients-19 boys and 11 girls, aged 15.3 (2) years (ran ge 11.3-20) at surgery were studied. Results-Surgical indications were acute complications of CD and chronic intestinal illness. Six months after surgery, 11 of 12 patients had been weaned off steroids, and 22 of 23 patients were weaned off nutritional support; 17 patients withou t recurrrence had a mean (SD) weight gain of 2.1 (8) kg and a height g ain of 3.36 (3) cm. During 3.1 (2.7) years follow up, 12 patients (40% ) had a recurrence of the disease after 19.4 (14) months (means (SD): supra-anastomotic recurrence (six), severe perianal disease (two), and chronic illness (four). Six of 14 patients who were treated with mesa lazine (13) or azathioprine tone) had recurrences. The postoperative r ecurrence rate was 50% at two years. Conclusion-Surgical treatment mod ifies the immediate outcome of severe or complicated CD, but does not prevent recurrence, despite localised resection or prophylactic postop erative treatment. Extension of the disease before surgery seems to be a major risk factor for postoperative recurrence in children.