Indications for and Results of Operation in Inflammatory Bowel Disease

Abstract

Of 363 patients with inflammatory bowel disease presenting between 1972 and 1983, 166 required definitive operation. A classification by histological type distinguishes Crohn's disease (CD) from ulcerative colitis (UC) and indeterminate inflammatory bowel disease. CD is divided into predominantly ileal disease (81), total or subtotal colonic disease (74) and distal disease (22), whilst UC is classified into colonic (95) or distal disease (63). Most patients with ileal disease required operation for chronic persistent symptoms. In patients with total colonic involvement a greater proportion of patients with CD than those with UC came to surgery. Very few patients with distal disease required surgery. After resection for ileal disease there was a low incidence of anastomotic leakage (3%) and no operative mortality. There was an overall operative mortality of 8% after colonic resection. This was much lower in the non-urgent cases but rose to 12% in urgent cases.

An Analysis of an Inflammatory Bowel Disease Practise in an Urban Community Hospital

“…In CD patients, the highest rate of surgery was for inflammation of the small bowel, with 80% of cases requiring at least one operation. This finding coincides with results reported by Schofield et al (7), who reported an operation rate of 86%. Analysis of the data from our study shows that CD is much more likely than UC to require surgery and that, of the different disease locations of CD, surgery seems to be performed least frequently for distal colonic involvement.…”

“…The distribution of CD and UC in the gastrointestinal tract only in part mirrored the published results (4,7). In CD patients, the small number of distal colitis cases was consistent with results found by Schofield et al 7, who found only 12.5% of CD inflammation to be distal.…”

“…Of UC and CD patients, only one of 110 of patients with distal colonic disease required surgery. This result was also noted in work by Schofield et al (7). These results can aid a physician in counselling a patient with distal IBD as to the likelihood of surgery during the course of the disease.…”

Thiopurine Therapy Is Associated with Postoperative Intra-Abdominal Septic Complications in Abdominal Surgery for Crohn’s Disease

“…Colocolonic anastomoses, however, did worse compared with other anastomoses; this accords with previous findings. [23][24][25] Earlier history of postoperative IASC and number of previous laparotomies for CD did not affect the outcome. Patients operated on more than once during the study were prone to suffer from more aggressive CD and also received AZA/6-MP more frequently.…”