Incidence of surgical resection for Crohn's disease

Abstract

One hundred fifty-two of 399 Crohn's patients (38 percent) diagnosed over 20 years, who lived within a geographically defined area at the time of diagnosis, underwent at least one operation. One hundred seventy-one resections were performed in 160 operations during a mean follow-up of 60 months. Forty-eight percent of patients had undergone their first resection within 10 years of diagnosis, and 39 percent of these had undergone a second resection within 10 years of the first. There was no difference between smokers and nonsmokers in the timing of their surgery.

European evidence based consensus on the diagnosis and management of Crohn's disease: special situations

“…It is lowest when the repeat resection rate is considered, intermediate when clinical indices are used, and highest when endoscopy is used as a diagnostic tool. [1][2][3][4][5][6][7][8][9][10] Data from endoscopic follow up of patients after resection of ileocaecal disease have shown that in the absence of treatment, the POR rate is around 65%-90% within 12 months and 80%-100% within three years of the operation. The clinical recurrence without therapy is about 20%-25% per year.…”

Postoperative Crohn’s disease recurrence: A practical approach

“…The occurrence of new mucosal (endoscopic) lesions in the neoterminal ileum early after surgery is almost constant, and it is followed in the mid-term by clinical symptoms and, in a proportion of patients repeated intestinal resections are required. As recently reviewed, clinical POR rates, assessed by conventional clinical activity indexes, varies between 17%-55% at 5 years, 32%-76% at 10 years and 72%-73% at 20 years [6] , whereas surgical POR rates (patients requiring re-operation) are of 11%-32% at 5 years, 20%-44% at 10 years and 46%-55% at 20 years [6][7][8] .…”

Ileal Crohn's disease is best treated by surgery

“…1 2 However, it is apparent that approximately 80% of patients presenting with ileal disease will require surgical intervention at some stage in their lifetime. [3][4][5] Realisation that the extent of disease resection and the extent of lymph node clearance does not affect disease recurrence rates, 6 7 and the increasing use of strictureplasty in obstruction, 8 has improved surgical strategies in Crohn's disease without compromising small bowel mucosal area. However, Crohn's disease cannot be cured by surgical intervention and thus the principles of management should include the relief of symptoms, minimising the risks of therapy and disease recurrence.…”