[Surgical treatment of Crohn's disease]

The experience with the surgical treatment of Crohn's Disease is analyzed in order to determine the indications for surgery, surgical procedures, postoperative complications and associated risk factors, and recurrence rates.

Retrospective analysis of patients operated upon for Crohn's Disease between 1979 and 1997. Risk factors for operative morbidity were searched, and actuarial curves for recurrence of disease were constructed.

There were 34 patients with a mean age of 46 years. All patients were operated upon because of complications; the most frequent ones were stenosis and obstruction. The affected patterns were ileocecal in 53%, colitis in 35% and small bowel in 12%. Segmental resections were the most frequent ones, mainly ileo-cecal. Operative morbidity was 32% and mortality 6%. The presence of colonic affection and the necessity of its resection was a higher risk for complications (P< 0.05). Actuarial recurrence was 39% at 107 months.

Surgery for Crohn's disease was mainly indicated in complications, presented high rates of morbidity associated with colonic involvement and resections, and there were high rates of recurrence at long-term.