[Crohn disease: resection therapy over the course of two decades]

Between 1972 and 1992 394 bowel resections were performed on 344 patients with Crohn's disease at the Surgical University Hospital Mannheim. The aim of this retrospective study was to examine the changes in indication, surgical technique, complication rate and mortality during this period. With the increasing incidence of Crohn's disease, the yearly number of resections has increased (from 9.8 to 30.8), while the frequency of emergency operations has declined (from 24.8% to 15.4%). During the last ten years, surgery was performed at an earlier stage; more often stenoses were resected before complications (chronic or acute intestinal obstruction, fistula and perforation) occurred. Complication rate and mortality has been reduced in the last ten years (complication rate: from 35.6% to 10.6%, mortality: from 3% to 0.7%). A significant higher complication rate was seen after emergency operations (37.1%) as compared to elective operations (12.6%) (p < 0.0001).