Grau A, Quintana C, Zuñiga A
Departamento de Gastroenterología, Escuela de Medicina, Universidad Católica de Chile, Santiago de Chile.
Rev Med Chil. 1993 Feb;121(2):162-6.
Surgery has an important role in the treatment of Crohn's disease (CD). The objective of this communication is to assess the results of surgical treatment in CD, trying to identify recurrence risk factors. A retrospective review of the charts of 120 patients with CD seen between 1963 and 1990 was made. One third of these patients required surgical treatment. The series was divided in two groups. Group A comprised patients treated from 1963 to 1977. Of these, 30% had ileal localization of the disease and 20 patients were submitted to 20 surgical procedures. The major surgical indication was intestinal obstruction and resection was performed in 85% of patients. Morbidity was 20% and mortality 10%. Group B comprised patients treated from 1978 to 1990. Nineteen patients were submitted to 22 surgical procedures. The disease was localized in the ileon in 50% of these patients. Twenty one surgical procedures were resective with a 9% complication rate and no surgical mortality. Eighty percent of patients in this group has a complete follow up. In 47% the disease recurred 37 months (as a mean) after surgery. No effect of age, sex or localization of the disease on the risk of recurrence was observed. It is concluded that morbidity and mortality of surgical treatment for Crohn's disease has decreased and a prolonged control of symptoms has been achieved. No recurrence risk factors were identified in this study.
手术在克罗恩病（CD）的治疗中起着重要作用。本交流的目的是评估CD手术治疗的结果，试图确定复发风险因素。对1963年至1990年间诊治的120例CD患者的病历进行了回顾性分析。其中三分之一的患者需要手术治疗。该系列分为两组。A组包括1963年至1977年接受治疗的患者。其中，30%的患者病变位于回肠，20例患者接受了20次手术。主要手术指征是肠梗阻，85%的患者进行了切除术。发病率为20%，死亡率为10%。B组包括1978年至1990年接受治疗的患者。19例患者接受了22次手术。这些患者中有50%病变位于回肠。21次手术为切除术，并发症发生率为9%，无手术死亡。该组80%的患者得到了完整随访。47%的患者在术后37个月（平均）复发。未观察到年龄、性别或病变部位对复发风险的影响。结论是，克罗恩病手术治疗的发病率和死亡率有所下降，症状得到了长期控制。本研究未发现复发风险因素。
