Dr Erlend Landsend and colleagues from Norway assessed the need for intestinal repeat resection for recurrence of Crohn's disease.
The patients were observed for more than 20 years after the first resection.
The research team collected data retrospectively from the medical records of 53 consecutive patients with Crohn's disease from 1954 to 2002.
Median age at first intestinal resection was 25 years, and median observation time after this was 27 years.
Disease location and behavior were defined according to the Vienna classification.
|There was a decrease in ileocolic disease from 45% to 5%|
|Scandanavian Journal of Gastroenterology|
The researchers noted that the patients had an average of 3 intestinal resections, and a total of 144 intestinal resections were performed.
The team observed that 77% of intestinal resections were performed during the first 3 operations.
No alterations in distribution of ileal, ileocolic and colic resections were found.
From the first to the third operation there was an increase in penetrating disease from 15% to 39%.
The team noted a concomitant decrease in stricturing disease from 72% to 44%.
There was also a corresponding decrease in ileocolic disease from 45% to 5%.
The researchers noted a tendency towards an increase in ileal disease from 38% to 67%.
After the third resectional operation, 1 patients died from rectosigmoid perforation after the third resectional operation.
The team identified that 11% of patients needed reoperation for ileus, anastomotic bleeding, rectosigmoidal perforation and abdominal pain.
In addition, 64% needed intestinal repeat resection during 25 years after the first repeat resection.
Dr Landsend's and colleagues concludes, “This study indicates a diminution of Crohn's disease activity with time, as demonstrated by no need for intestinal repeat resection more than 25 years after the first resection.”