[Recurrence after intestinal resection for Crohn's disease]

Although recurrence is one of the major problems in the surgical management of a patient with Crohn disease, the factors that influence recurrence rate remain controversial. To elucidate some of this controversy, the records of a consecutive series of 100 patients, who underwent resectional surgery for Crohn's disease, were analyzed to evaluate the effect of several clinical and histologic features on the recurrence rate. In this study, recurrence was defined as clinical and or laboratory findings of re-emergent disease confirmed by objective means after resection of all lesions. Recurrence rate seems lower in colitis than ileitis or ileocolitis, but this data did not reach statistic significance; the site of recurrence was conditioned by the initial location of the disease and the extent of resection into healthy tissue above and below the lesions and the histological findings of section lines did not modify the risk of recurrence. In conclusion the recurrence is almost inevitable. The multifactorial aspect of the recurrence cannot be ignored, however some clinical factors were more closely related to the recurrence. A part from Crohn's colitis, type of surgery (radical vs limited resection) had little chance of minimizing the risk of recurrence.