Crohn's disease: the role of surgical treatment.

The surgical treatment of Crohn's disease is necessitated by complications of the disease or by failure of medical therapy. Despite the fact that the patients with Crohn's disease who undergo operation have the most severe spectrum of problems, about half these patients may never need a further procedure, and the mortality from the disease itself is low. During the past 50 years, the concepts of surgical treatment for Crohn's disease have gradually evolved, and the current feeling among surgeons can be summarized best in the word "moderation." In this article, general guidelines for treatment and the results of various procedures for Crohn's disease are presented, including discussion of the complications of chronic obstruction, fistulization and abscess, bleeding, intractability, and toxic megacolon.