The Treatment and Prognosis of Crohn's Disease S. Tsuchiya 1 , K. Takemura 1 1Second Department of Surgery, Yokohama City University pp.517-526
Published Date 1978/4/25
DOI https://doi.org/10.11477/mf.1403107276
  • Abstract
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 Although no specific therapy has been reported for Crohn's disease, the initial treatment of this disorder is generally medical.

 But about 60~70% of patients eventually come to surgery on account of complications. According to the Survey by Crohn's disease Research Committee of Japan 1977, 120 of 127 cases exactly fulfilling diagnostic criteria underwent operation. Obstruction was the commonest indication for surgery followed by intractability.

 Unfortunately, surgical therapy is not always curative and the rate of recurrence is usually high postoperatively. Resection is thought to be preferable to exclusion or bypass, if the local condition is allowable. Because complete removal of the area involved is not a guarantee against recurrence, massive bowel resection is not indicated for the extensive involvement of the small intestine.

 During the recent four years, nine patients were diagnosed as having Crohn's disease at our surgical department. The sites of involvement were the ileum and colon in 5, the colon in 2 and the rectum in 2.

 On these, 5 underwent operation (resection : 3, resection and exclusion ; 1, exclusion only : 1).

 Symptomatic relief and improvement of the laboratory data were obtained immediately after each surgical procedure. Recurrence developed at an ileal segment remote from the anastomotic site in a patient having had resection for the ileal disease and exclusion of the rectum for the ileorectal fistula.

 Discussion on the treatment and prognosis of Crohn's disease is presented with a review of the recent medical and surgical literature

Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.


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