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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 1999 April;12(2):101-6
Postoperative complications in Crohn's disease. Are they related to recurrence promoting factors? A preliminary study
Fronda G. R., Resegotti A., Astegiano M., Sostegni R., Giustetto A., Soldati T., Fusi D., Sabbatino F., Fornari M.
Background. Many papers can be found in the literature about postoperative recurrence of Crohn's diseases; on the contrary data on postoperative course of patients operated on for Crohn's disease are very few.As a relation between operative complications and recurrence of Crohn's disease has been identified by others, it was decided to investigate if th same factors could promote recurrence and increase operative morbidity. The aim was to see if operative mortality and morbidity could be related to age, sex, clinical pattern. fistulae,previous surgery, simultaneous surgical procedures, steroids and emergent surgery. Many of those factors have been related to an earlier recurrence of the disease by others.Methods. From November 1993 to February 1997, seventy-nine patients underwent a total of 85 interventions for Crohn's disease; only resectional interventions on small or large bowel are included. Data were collected prospectively, on a personal computer database.Results. Mortalibty was 3,5%. Patients who deceased were older than those who survived, all were male, all had fistulae, all were on steroids and all have been operated on in an emergency setting.Morbidity was 23,2%; the following factors were identified as possibly related to an increased morbidity: male sex, colonic clinical pattern,fistulae, previous surgery, steroids. If only major surgical complications are taken into account, the importance of those factors is even more striking.Conclusions.As this is a preliminary work, the conclusion is drawn that there is some evidence that operative morbidity in Crohn's disease may be related to some factors, influencing also disease recurrence; this hypothesis deserves further investigation.