Sevket Yilmaz Teaching and Research Hospital, Department of Gastroenterological Surgery, Bursa, Turkey.
Sakarya University, Faculty of Medicine, Department of General Surgery, Sakarya, Turkey.
Int J Surg. 2015 Mar;15:49-54. doi: 10.1016/j.ijsu.2015.01.029. Epub 2015 Jan 31.
The diagnosis of Crohn's disease is based mainly on the patient's history and clinical examination and supported by serologic, radiologic, endoscopic, and histologic findings.
The main purpose of the present study was to evaluate in a retrospective manner the clinico-pathological characteristics of patients who underwent surgery due to stricturing or non perineal fistulizing Crohn's disease.
Between January 2007 and June 2012, 75 patients who were operated on for stricturing and non-perineal fistulizing forms of Crohn's disease were analyzed according to their clinico-pathological characteristics.
The L3 localization (Montreal Classification) was detected significantly more often in the non-perineal fistulizing group than in the stricturing group (P < 0.03). Wound infection (18 patient, 24%) was the most commonly observed postoperative complication, followed by postoperative ileus (5 patients, 6.7%) and intraabdominal abscess (4 patients, 5.2%). The distribution of postoperative complications according to the two groups was not significantly different (P = 0.772). Submucosal fibrosis, ulcers and transmural inflammation were the three most common histopathological signs in resected specimens from both groups. Pseudopolyps, microabscess, granuloma, mononuclear inflammation and deep fissures were significantly far more frequent in the non perineal fistulizing group when compared to the stricturing group (P < 0.05). On the other hand, superficial ulcers were significantly more frequent in the stricturing group (P = 0.007).
No specific clinical feature was found to differentiate patients with the stricturing form of Crohn's disease from the fistulizing form. However, histopathological analysis of the resected specimens revealed significant differences in some parameters between the two disease forms.
克罗恩病的诊断主要基于患者的病史和临床检查，并辅以血清学、影像学、内镜和组织学发现。
本研究的主要目的是回顾性评估因狭窄或非肛周瘘管性克罗恩病而行手术的患者的临床病理特征。
2007 年 1 月至 2012 年 6 月，对 75 例因狭窄和非肛周瘘管性克罗恩病而行手术的患者，根据其临床病理特征进行分析。
在非肛周瘘管性组中，L3 定位（蒙特利尔分类）的检出率明显高于狭窄组（P<0.03）。术后并发症中，最常见的是伤口感染（18 例，24%），其次是术后肠梗阻（5 例，6.7%）和腹腔脓肿（4 例，5.2%）。两组术后并发症的分布无显著差异（P=0.772）。两组患者切除标本中最常见的组织病理学特征为黏膜下纤维化、溃疡和透壁性炎症。与狭窄组相比，非肛周瘘管性组中假息肉、微脓肿、肉芽肿、单核细胞炎症和深部裂隙更为常见（P<0.05）。另一方面，在狭窄组中，浅层溃疡更为常见（P=0.007）。
没有发现特定的临床特征可以区分狭窄型和瘘管型克罗恩病患者。然而，对切除标本的组织病理学分析显示，两种疾病形式之间在某些参数上存在显著差异。
