[Surgical treatment of Crohn disease of the colon and rectum].

Colon can be affected by Crohn's disease together with the small intestine, as a direct extension from the diseased ileum, as an isolated disease with "skip lesions" or as an specific pathological entity. Experiences in the surgical treatment of 28 cases of isolated Crohn's disease of large intestine during the period 1980-1997 are presented. The overall mortality was 21.4%, and all operative procedures quoted in literature were used. The most common operation performed was colectomy with ileorectoanastomosis, in one or two stages (24.9%). Crohn's disease of colon is more persistent that fatal disease. With conservative or carefully elected operative treatment it is often possible to maintain good comfort and Quality of life, with restored continuity of digestive tract, for a long time. According to the literature, after removing of the diseased segment of large intestine, the recurrences are observed in more than 60% in longer postoperative period requiring permanent ileostomy. These recurrences seem to be more dependent of the natural history of disease, than of the choice of operation. In spite of the progress of medical treatment, the operative management is necessary in more than 70%, due to various surgical complications. The perianal form of the disease is to be treated medically, or by sparing surgical procedures.