Long-term follow-up in Crohn's disease. Mortality, morbidity, and functional status.

BACKGROUND

The purpose of this study was to analyse long-term results of an active approach to surgical treatment of Crohn's disease.

METHODS

One hundred and thirty-six patients were studied after first resection for primary Crohn's disease during 1968-77.

RESULTS

Mean follow-up was 16.6 years; 18 patients had died (3 of Crohn's disease). Cumulative risk for a second resection was 0.40 (95% confidence interval, 0.29-0.51) at 10 years and 0.45 (0.32-0.58) at 15 years, similar in classical disease and colitis. Cumulative risk of a third and fourth resection was 0.5 at 10 years. Median resected bowel length at the first operation was 8%. After two and three resections the cumulative resection was 23% and 33%, respectively. Of the patients 73% claimed full working capacity and 7% had disability pension.

CONCLUSIONS

An active surgical approach in Crohn's disease is associated with low operative mortality and morbidity and good functional results and offers good symptomatic relief.