Long-term results and multivariate analysis of prognostic factors in 138 consecutive patients operated on for Crohn's disease using "bowel-sparing" techniques
M. Cristaldi et al., Long-term results and multivariate analysis of prognostic factors in 138 consecutive patients operated on for Crohn's disease using "bowel-sparing" techniques, AM J SURG, 179(4), 2000, pp. 266-270
BACKGROUND: Conservative surgery has become accepted as a useful option for
the surgical treatment of complicated Crohn's disease (CD).
METHODS: One hundred thirty-eight consecutive patients treated with strictu
replasty or miniresections for complicated CD have been observed prospectiv
ely. The possible influence of a number of variables on the risk of recurre
nce was investigated using the Cox proportional hazard model, and a time-to
-event analysis was made using the Kaplan-Meier function.
RESULTS: There was no perioperative mortality; the morbidity rate was 5.7%.
A close correlation was found between the risk of recurrence and the time
between diagnosis and first surgery. The overall 5-year recurrence rate was
24%, being 36% in the patients requiring surgery within 1 year of diagnosi
s and 14% in those operated on more than 1 year after diagnosis.
CONCLUSIONS: Risk factor analysis highlighted a group of patients at high r
isk of surgical recurrence. Given that our results are similar to those rep
orted in other series, we consider stricture-plasty and miniresections safe
and effective procedures for the treatment of complicated CD. Am J Surg. 2
000;179:266-270. (C) 2000 by Excerpta Medica, Inc.