[Surgical therapy of recurrent Crohn disease]

The surgical therapy of recurrent Crohn's disease requires due to a recurrence rate of 60% after 15 years special precautions. The major principle of therapy is a minimal resecting surgery. This concerns mainly strictures and stenosis. Strictures should be treated by stricturoplasty and stenosis by limited resection. Recurrent fistulas should be treated conservatively. Just in case of interenteric and enterocutaneous fistula with a concomitant short bowel syndrome, in blind ending fistulas with an abscess or in enterovesical fistulas we recommend immediate operation. The therapy of recurrent anorectal Crohn's disease underlies the same rules as the primary therapy. If necessary, proctectomy remains an important option. Also emergency surgery in recurrent Crohn's disease follows the same rules as in elective surgery.