The surgical treatment for Crohn's disease

Chirurgia (Bucur). 2013 Jul-Aug;108(4):463-7.

Abstract

Introduction: Crohn's disease is a chronic idiopathic medical and surgical disease, in which the transmural intestinal inflammatory process frequently leads to complications such as strictures or fistulae. The disease is considered to be the result of an imbalance between the proinflammatory mediators and the anti-inflammatory ones; it can be localized on any segment of the gastrointestinal tract, but it especially affects the terminal ileum. The purpose of the study is to assess Crohn's disease from the point of view of the complications requiring surgical treatment, the manner in which they are solved, as well as the postoperative evolution.

Material and method: we followed retrospectively the patients hospitalized and operated in our department during the period January 2001 - December 2011. We examined the clinical observation charts, the paraclinical investigations, the surgical protocols and the histopathological results.

Results: the 11 patients included in the study underwent 13 surgical interventions. Their ages were comprised between 16 and 67, the average age being 42.9. The men women ratio was 7 4 (1.75); the interventions performed were segmental enterectomies, right ileo- hemicolectomy, ileotransverse anastomosis, an exploratory laparotomy and an exploratory laparoscopy.

Conclusions: the purpose of the treatment of Crohn's disease is to obtain the best possible clinical, laboratory and paraclinical control of the inflammatory process with the least adverse reactions to the medication. The surgical indications for the treatment of the disease are imposed by severe complications such as perforation, stenosis, fistulisation and even malignancy. Consequently, although Crohn's disease is a chronic disease with many relapses, the correct medical and surgical treatment helps patients to maintain a reasonable quality of life, with a good prognosis and a very low mortality rate.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anastomosis, Surgical
  • Colectomy* / methods
  • Crohn Disease / pathology*
  • Crohn Disease / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Quality of Life
  • Retrospective Studies
  • Treatment Outcome