[Crohn's disease: clinical presentation and results of surgical treatment]

Surgery has an important role in the treatment of Crohn's disease (CD). The objective of this communication is to assess the results of surgical treatment in CD, trying to identify recurrence risk factors. A retrospective review of the charts of 120 patients with CD seen between 1963 and 1990 was made. One third of these patients required surgical treatment. The series was divided in two groups. Group A comprised patients treated from 1963 to 1977. Of these, 30% had ileal localization of the disease and 20 patients were submitted to 20 surgical procedures. The major surgical indication was intestinal obstruction and resection was performed in 85% of patients. Morbidity was 20% and mortality 10%. Group B comprised patients treated from 1978 to 1990. Nineteen patients were submitted to 22 surgical procedures. The disease was localized in the ileon in 50% of these patients. Twenty one surgical procedures were resective with a 9% complication rate and no surgical mortality. Eighty percent of patients in this group has a complete follow up. In 47% the disease recurred 37 months (as a mean) after surgery. No effect of age, sex or localization of the disease on the risk of recurrence was observed. It is concluded that morbidity and mortality of surgical treatment for Crohn's disease has decreased and a prolonged control of symptoms has been achieved. No recurrence risk factors were identified in this study.