McDonald P J, Fazio V W, Farmer R G, Jagelman D G, Lavery I C, Ruderman W B, Easley K A, Harper P H
Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio 44106.
Dis Colon Rectum. 1989 Feb;32(2):117-20. doi: 10.1007/BF02553823.
Four hundred eighty-six patients who have had resections for Crohn's disease at the Cleveland Clinic were reviewed. The patients were categorized by indication for surgery into three groups: perforating (P) (135 patients), nonperforating (NP) (278 patients), and miscellaneous (M) (77) patients. One hundred ninety-four patients had two or more resections and 56 underwent a third resection. Patients were no more likely to have the same indication for surgery at the time of the second resection (P = 25 percent; NP = 44 percent; M = 57 percent) or the third resection (P = 11 percent; NP = 65 percent; M = 55 percent). There was also no difference in the interval between resections for the P and NP groups. The lack of agreement between resections suggests that the categorization of patients into P and NP groups does not facilitate prediction of the nature of recurrent disease. The concept of aggressive perforating and indolent nonperforating Crohn's is not substantiated by this study.
对在克利夫兰诊所因克罗恩病接受切除术的486例患者进行了回顾性研究。根据手术指征将患者分为三组：穿孔型（P）（135例患者）、非穿孔型（NP）（278例患者）和其他型（M）（77例患者）。194例患者接受了两次或更多次切除术，56例患者接受了第三次切除术。在第二次切除术时（P组=25%；NP组=44%；M组=57%）或第三次切除术时（P组=11%；NP组=65%；M组=55%），患者再次手术的指征不太可能相同。P组和NP组两次切除术之间的间隔也没有差异。两次切除术之间缺乏一致性表明，将患者分为P组和NP组并不能有助于预测复发性疾病的性质。本研究并未证实侵袭性穿孔型和惰性非穿孔型克罗恩病的概念。
