Khaitov Sergey, Nissan Aviram, Beglaibter Nahum, Freund Herbert
Department of Surgery, Hadassah University Hospital, Mount Scopus.
Harefuah. 2003 Mar;142(3):179-81, 239.
Crohn's disease is an inflammatory disorder that affects various parts of the gastrointestinal tract. The management of Crohn's disease involves various anti-inflammatory and antibiotic agents while the role of surgery is limited to the treatment of disease associated complications. During recent years surgical therapy was also advocated for the improvement of the quality of life in patients with incapacitating Crohn's disease. In a previous study we demonstrated both the safety and efficacy of bowel-preserving surgery in a group of patients with Crohn's disease with no absolute indication for surgery, but with severe impediment of their quality of life due to severe disease activity and its therapy. The present study was undertaken to evaluate the long-term outcome of this group of patients. Fifteen Crohn's disease patients operated on for the improvement of the quality of life were followed for a median of 106 (range 82-132) months. During this time only 27% of the patients required reoperation for the treatment of recurrent Crohn's disease. The median surgery-free interval was 92.6 months and the 10-year surgery-free survival was 72%. Based on our results in this small group of patients, we suggest that there is a long-term benefit of surgical therapy for patients with Crohn's disease operated on in an attempt to improve their quality of life.
克罗恩病是一种影响胃肠道各个部位的炎症性疾病。克罗恩病的治疗涉及多种抗炎和抗生素药物，而手术的作用仅限于治疗与疾病相关的并发症。近年来，手术治疗也被提倡用于改善重度克罗恩病患者的生活质量。在之前的一项研究中，我们证明了在一组没有绝对手术指征，但因严重疾病活动及其治疗导致生活质量严重受损的克罗恩病患者中，保留肠段手术的安全性和有效性。本研究旨在评估这组患者的长期预后。对15例因改善生活质量而接受手术的克罗恩病患者进行了随访，中位随访时间为106个月（范围82 - 132个月）。在此期间，只有27%的患者因复发性克罗恩病需要再次手术。无手术间隔的中位时间为92.6个月，10年无手术生存率为72%。基于我们在这一小群患者中的结果，我们认为对于为改善生活质量而接受手术的克罗恩病患者，手术治疗具有长期益处。
