PP 74. Long-Term Outcome of Intestinal Failure Requiring Home Parenteral Nutrition in Patients with Crohn’s Diseas

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

16:30 - 16:36h at Margrit Room

Categories: Gastrointestinal Surgery, Poster Session

Session: Poster II (P1) - Gastrointestinal Surgery

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Background
Patients with Crohn's disease (CD) often require several surgeries in their lifetime, and some of the patients having polysurgery finally necessitate home parenteral nutrition (HPN) therapy because of intestinal failure (IF). The aim of this study was to investigate the long-term outcome of CD who underwent surgical therapy in terms of IF.

Material and Methods
We reviewed clinical record of patients who underwent initial operation for intestinal lesions of CD from 1973 to 2012 in our hospital.

Result
A total number of 280 CD patients underwent initial surgery during this period . IF occurred in 16 patients (13 male, 3 female). Median age at the time of onset of IF, and the duration from surgery to onset of IF were 34 years (range: 28-66), and 9 years (2-20). Median number of laparotomies before starting HPN was 3 (1-5), length of the remaining jejunoileum was 145 cm (100-280), and all 16 patients underwent surgery for the colon; ileocolic valve was resected in 13, ileostomy was constructed in 2, and colostomy was constructed in 1. Mortality rate was 13% (2 of 16), and both died of cancer but not of complications related to IF. Cumulative rate of IF was 7% in 10 years, and 18% in 20 years after the initial surgery.

Conclusion
The incidence of IF in CD patients was not low. Length of the jejunoileum shorter than 150 cm and surgery for the colon could be the risk factors for IF in patients with CD.