Sugita A, Fukushima T, Yamazaki Y, Harada H, Goh K, Koganei K, Tsuchiya S
Second Department of Surgery, Yokohama City University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1993 Feb;94(2):114-8.
Postoperative recurrence rate and recurrence form were analyzed in two clinical forms of Crohn's disease at primary resection, one of which was perforating and the other was non perforating. Forty four patients with Crohn's disease were included in this study, 18 of them were perforating type and 26 were non perforating type. Crude recurrence rates were 39% (7/18 cases) in perforating type group and 54% (14/26 cases) in non perforating type group, which were not significantly different. Cumulative recurrence rates 5 years after initial operation were 58% in perforating type group and 47% in non perforating group without statistically significance. The recurrence form was perforating type more frequently in perforating type group (86%) than non perforating group at primary resection (29%) with statistically significance (p = 0.013). Postoperative recurrence form had a tendency to be similar to the form at primary resection. It was suggested from this study that Crohn's disease had two different disease entities; perforating and non perforating types and that postoperative recurrence should be examined carefully from the view of primary resection.
对克罗恩病初次切除时的两种临床类型(一种为穿孔型,另一种为非穿孔型)的术后复发率及复发形式进行分析。本研究纳入了44例克罗恩病患者,其中18例为穿孔型,26例为非穿孔型。穿孔型组的粗复发率为39%(7/18例),非穿孔型组为54%(14/26例),二者无显著差异。初次手术后5年的累积复发率,穿孔型组为58%,非穿孔型组为47%,无统计学意义。在穿孔型组,复发形式为穿孔型的比例(86%)高于初次切除时为非穿孔型的组(29%),具有统计学意义(p = 0.013)。术后复发形式倾向于与初次切除时的形式相似。本研究提示,克罗恩病存在两种不同的疾病实体,即穿孔型和非穿孔型,且应从初次切除的角度仔细检查术后复发情况。