SURGICAL HISTORY OF CROHNS-DISEASE IN A WELL-DEFINED POPULATION

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  • 1 January 1982
    • journal article
    • research article
    • Vol. 57  (12) , 747-752
Abstract
Since 1935, 42 of 103 residents of Olmsted County, Minnesota, [USA] identified as having Crohn''s disease underwent 1 or more surgical procedures. The incidence and type of surgical intervention, distribution of disease and risk of recurrent disease after surgery were analyzed. Follow-up extended to 32 yr, with a median of 8.5 yr. Patients (36) underwent at least 1 definitive resection; 8 of these patients subsequently underwent a 2nd definitive operation. The likelihood that any patient would undergo operation was greatest within the 1st yr of diagnosis. The proportion of patients in whom recurrent disease developed after the 1st and 2nd definitive resections was 50% and 37%, respectively. Approximately half the patients who experienced a recurrence underwent further surgery. The site of diseased bowel and sex were not factors specifically influencing recurrence rates. Patients 40 yr of age and older who underwent surgery appeared to fare better with respect to recurrent disease than younger patients. Although these findings suggest cumulative risks of recurrent disease after definitive resection similar to those reported from larger population groups or major referral centers, the proportion of patients who underwent surgery during the natural history of their Crohn''s disease was much less than generally reported. Operation of Crohn''s disease apparently is not inevitable and evidence to the contrary may imply both a treatment and a referral bias.

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