PP 08. Outcome Of Surgical Treatment For Crohn’S Disease

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S. Haneda, S. Ohnuma, H. Musha, T. Morikawa, M. Nagao, T. Abe, N. Tanaka, K. Kudoh, H. Sasaki, A Kohyama, T. Aoki, H. Karasawa, M. Obara, E. Kono, H. Hayashi, K. Nakagawa, H. Yoshida, F. Motoi, C. Shibata, Y. Katayose, T. Naitoh, M. Unno

18:52 - 18:58h at Margrit Room

Categories: Gastrointestinal Surgery, Poster Session

Session: Poster (P1) - Gastrointestinal Surgery

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Background
Patients with Crohn's disease (CD) often require several surgeries in their lifetime. Aim of this study was to investigate outcome of surgical treatment.

Material and Methods
We reviewed clinical record of patients who underwent initial operation for intestinal lesions of CD between 1968 and 2011.

Result In total,
257 patients (190 men, 67 women) underwent surgery. Median age at the time of surgery, and the duration from onset of CD to operation were 27 (13-73), and 4 (0-33) years. Indication for surgery was stricture in 204 patients (80%), fistula in 74 (29%), perforation in 16 (6%), and others in 32 (12%). Performed procedures were large bowel resection in 174 patients (68%), small bowel resection in 76 (30%), strictureplasty in 73 (24%), stoma in 41 (16%), and others in 6 (2%). Mortality rate was zero, and morbidity rate was 22% (56 patients) in the early postoperative period; wound infection in 32 (12%), ileus in 12 (5%), and others in 15 (6%). Re-operation rate within 1 month after the operation was 2% (5 patients). Cumulative 5 and 10-year re-operation rate were 35% and 60%. Sixteen patients (6%) required home parenteral nutrition therapy for intestinal failure. Six patients (2%) died of cancer associated with CD at the median age of 41 years.

Conclusion
Short-term results of our surgical therapy for CD were considered satisfactory. However, in the long-term results, high rate of recurrence, intestinal failure, and cancer death at young age are the issues we have to solve.