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Postoperative Course of Crohn's Disease -In regard to Recurrence and Residual Disease at Anastomosis -


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Title: Postoperative Course of Crohn's Disease -In regard to Recurrence and Residual Disease at Anastomosis -
Authors: Shimoyama, Takatoshi / Takahira, Ryohji / Kusano, Hiroyuki / Shimizu, Teruhisa / Ishikawa, Hiroshi / Miyashita, Kohsei / Kawazoe, Naoki / Kurosaki, Nobuko / Nakagoe, Tohru / Hirano, Tatsuo / Miura, Toshio / Tomita, Masao / Makiyama, Kazuya / Ifuku, Masumi / Tobinaga, Kohji / Adachi, Akira
Issue Date: 9-Dec-1989
Citation: Acta medica Nagasakiensia. 1989, 34(2-4), p.126-133
Abstract: Twenty-seven patients with Crohn's disease who were operated on at the First Department of Surgery, Nagasaki University School of Medicine and followed-up after surgery were reviewed. Involved portion of intestinal tract were 10 in small bowel only, 14 in both small and large bowels, and 3 in large bowel. Major indication for surgery were obstruction, fistula, peritonitis and intractability of medical therapy. Twenty-two patients underwent radical resection and the other 5 patients had the disease left behind at anastomosis. The recurrence rate was 25.9% (7 out of 22), and early recurrence was found in small bowel diseases with longitudinal ulcerations or multiple aphthoid ulcers. Initial recurrence occured near the suture line, which showed no wide spreading in subsequent periods. Two cases with both small and large bowel disease required reoperation over 5 years after initial surgery because of stenosis. Three out of five cases with residual disease at the intestinal resection margin had a good condition, but the other three cases with skip sigmoid disease were intractable for medical therapy. Most suture line recurrence and residual disease at anastomosis were sufficiently managed by postoperative medication for long periods of time. Long-term follow-up study showed a good quality of life in about 75% of these cases. In conclusion, conservative resection rather than the sacrifice of normal bowel should be recommended for an extended disease of small bowel.
URI: http://hdl.handle.net/10069/15774
ISSN: 00016055
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 34, No. 2-4

Citable URI : http://hdl.handle.net/10069/15774

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