Does the histologic appearance at the margin of resection affect the postoperative recurrence rate in Crohn's...

Is there a role for radical surgery in the management of Crohn's disease or is it feasable to perform limited resections without increasing the risk of recurrence? Fifty eight patients with Crohn's disease underwent resection with subsequent anastomosis. A follow-up of at least 3 years (range, 3-15 years) was undertaken in all cases. All resected specimens at primary surgery were reviewed by one gastrointestinal pathologist to evaluate, retrospectively, the influence of residual microscopic disease at resectional margins on recurrence rate. No statistically significant difference was reported between patients with involved margins and those without such findings as to recurrence rate, interval between primary surgery and reoperation at site of recurrent disease. This review does not provide evidence for adverse influence of residual microscopic disease at the margins of resection. Therefore, limited resection of macroscopically diseased bowel is recommended. One must bear in mind the high rate of recurrence with the necessity of reresection.