[The place of surgery and its influence on recurrence in the evolution of Crohn's disease]

This retrospective study analyses the results of 37 patients suffering from Crohn's disease and submitted to surgery. 49 operations were carried on with a follow up ranging from 24 to 276 months. Lesions were mainly located in the ileo-colic segment (24 cases) the rectum (8 cases), the colon (9 cases) and the anus or rectum (10 cases). The operative mortality was about 8% and long term results show an overall recurrence rate of 66.6%, the average follow up being 88 months. Nutritional complications associated with a constant increase of the recurrence rate should lead to avoid reiterated resections. A conservative therapy under medical surveillance is then indicated and in case of surgical management, parsimonious resections are required but the anastomosis should not involve pathological tissues. The surgical management of Crohn's disease being a temporary and sometimes mangling solution should only be required in case of medical treatment failure or while facing evolution complications.