Crohn's disease. Recurrence after surgical treatment

A series of 76 patients who have undergone surgical treatment for Crohn's disease is presented. In 14 of the patients surgery was performed for recurrence after previous resection. In total, 91 intestinal resections and one bypass--operation were carried out. Postoperative mortality comprised 4 patients (5.3%), and there were 4 late deaths. Sixty-six patients were followed up for periods ranging from 2 to 11 years, with a median of 4.0 years. Recurrence rates and reoperation rates were determined by actuarial analyses. The yearly recurrence rate seemed constant during the observation period, averaging 15.2%, and the cumulative recurrence rate was thus 77% after 9 years. The reoperation rate also seemed to be constant, and on the average 5.5% per year, and the cumulative reoperation per cent after 9 years was 45. There was no significant difference between cumulative recurrence rates after primary operations and after operations for recurrence. There was a significantly higher risk of relapse during the first year after non-radical excision of the diseased part of the gut than after radical excision. The majority of the patients were in good general condition at time of review; only 3 patients suffered from marked symptoms with reduced working capacity.