[Surgical treatment of Crohn disease of the colon. (38 cases) (author's transl)].

From 1959 to december 1972 thirty-eight patients out of sixty having Crohn disease of the colon alone or with ileal and/or rectal involvement were operated upon. We had four post-operative deaths and one a long time after the intervention, but in relation with the initial Crohn disease. These thirty-eight patients had sixty-seven operations. Only fifty-five per cent of the operated on patients did not have any complications. Twenty-three patients had recurrence of the disease, seven of them were re-operated for this first recurrence, two of them for a second recurrence and one of these two last patients had a third recurrence. That makes twenty-seven recurrences out of forty-three resections. Among these twenty-seven recurrences, in at least seventeen cases, resection was not large enough or was not radical. Three quarters of the recurrences appear during the first year. The more exposed interventions to recurrences are left hemi-colectomies (two out of two) and total colectomies with ileo-rectal anastomosis (six out of eight). The ones that give less recurrences are total colo-protectomies or subtotal colectomies (one recurrence out of nine). Indications for the different types of interventions are analysed. Management of the rectum in Crohn disease of the colon is difficult. Procedures applied for toxic megacolon are equally very critical.