Nygaard K, Fausa O
Scand J Gastroenterol. 1977;12(5):577-84. doi: 10.3109/00365527709181336.
A series of 76 patients who have undergone surgical treatment for Crohn's disease is presented. In 14 of the patients surgery was performed for recurrence after previous resection. In total, 91 intestinal resections and one bypass--operation were carried out. Postoperative mortality comprised 4 patients (5.3%), and there were 4 late deaths. Sixty-six patients were followed up for periods ranging from 2 to 11 years, with a median of 4.0 years. Recurrence rates and reoperation rates were determined by actuarial analyses. The yearly recurrence rate seemed constant during the observation period, averaging 15.2%, and the cumulative recurrence rate was thus 77% after 9 years. The reoperation rate also seemed to be constant, and on the average 5.5% per year, and the cumulative reoperation per cent after 9 years was 45. There was no significant difference between cumulative recurrence rates after primary operations and after operations for recurrence. There was a significantly higher risk of relapse during the first year after non-radical excision of the diseased part of the gut than after radical excision. The majority of the patients were in good general condition at time of review; only 3 patients suffered from marked symptoms with reduced working capacity.
本文报告了76例接受克罗恩病手术治疗的患者。其中14例患者因先前切除术后复发而接受手术。总共进行了91次肠切除术和1次旁路手术。术后死亡率为4例（5.3%），有4例晚期死亡。66例患者随访时间为2至11年，中位数为4.0年。复发率和再次手术率通过精算分析确定。在观察期内，年复发率似乎保持恒定，平均为15.2%，因此9年后累积复发率为77%。再次手术率似乎也保持恒定，平均每年5.5%，9年后累积再次手术率为45%。初次手术和复发手术后的累积复发率之间无显著差异。肠道病变部位非根治性切除术后第一年的复发风险明显高于根治性切除术后。在复查时，大多数患者一般状况良好；只有3例患者有明显症状且工作能力下降。
