Alexander-Williams J, Fielding J F, Cooke W T
Gut. 1972 Dec;13(12):973-5. doi: 10.1136/gut.13.12.973.
One hundred and ten patients presented with Crohn's disease confined to the terminal ileum, and indications for their surgical treatment are reviewed. Treatment was either by ileo-transverse side-to-side bypass (21 patients) or primary excision and end-to-end ileo-colic anastomosis (89 patients). In a long follow up (mean 13.8 years) the date and indications for the second major operative intervention are recorded. The cumulative risk of recurrence recorded each year after the primary operation shows that after bypass compared with excision there is approximately twice the risk of requiring a further major operation. After bypass the indication for the second operation is usually a local complication of the still active disease and after excision it is usually a juxta-anastomotic recurrence with stenosis.
110例患者患有局限于回肠末端的克罗恩病，对其手术治疗指征进行了回顾。治疗方式为回肠-横结肠侧侧吻合术（21例患者）或一期切除及回肠-结肠端端吻合术（89例患者）。在长期随访（平均13.8年）中，记录了第二次主要手术干预的日期和指征。初次手术后每年记录的复发累积风险显示，与切除术后相比，旁路术后需要再次进行主要手术的风险约为两倍。旁路术后第二次手术的指征通常是仍处于活动期疾病的局部并发症，而切除术后通常是吻合口旁复发伴狭窄。
