[Intestinal resection in the treatment of Crohn disease. Retrospective study of a series of 106 cases].

Crohn's disease needs medical and surgical management. Most patients are operated and surgical procedure the most often realised is intestinal resection. The authors report their experience of 106 intestinal resection performed between 01/01/1980 and 31/12/1992, in the "service de Chirurgie C" of the "CHU de Nancy" for patients operated for the first time for Crohn's disease. They were 54 men and 52 women with an average age of 31.7 years at operative time. The following clinical patterns were established: small intestine 36, colonic 10 and ileocolic 60 patients. The average length of evolution before surgery was 4.5 years. The main indication was intestinal obstruction in small intestine patterns (91%) and poor response to medical therapy in colonic patterns (30%). Usual surgical procedure was to remove all visibly diseased bowell with healthy margin of resection, as judged by gross examination, of 3 to 5 cm. Postoperative morbidity was low (17.9%) with 3 anastomotic leakages. Postoperative morbidity was 1.9% (2 patients). The average duration of follow-up was 4 years. Among the 106 patients operated for the first time for their Crohn's disease, 19 (18%) were operated again, at least one time, during the follow-up. The quality of life of operated patients is considered as good with only one patient very invalidated by a short small bowel syndrome. According to the data of their series and the literature, the authors conclude that in Crohn's disease, excisional surgery is able to improve patients clinical status account to a low morbidity and mortality, with a low risk of short small bowel syndrome as clinical course but it does not avoid recurrence.