Crohn 病の外科的治療成績と再発様式について-自験36例の検討-

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Thirty-six patients with Crohn's disease who underwent surgery were included in this study. The mean age at the time of surgery was 23.5 years. The anatomical distribution was the small intestine in 20 patients (55.6 %), the small and large intestine in 13 (36.1 %) and the large intestine in three (8.3 %). Conditions for wihch surgery was indicated were stenosis, fistula and abscess in 83 %. Eleven (36.6 %) of these patients required further operation : We studied the correlation between intraoperative endoscopic findings and recurrence in 26 cases, which were divided into three groups on the basis of residual lesions : Group A consisted of 9 patients with longitudinal ulcer and/or cobblestone appearance in residual lesions, among whom recurrence developed in 8. Relapse of residual lesions developed in 4 patients but required no further surgery, whereas suture line recurrence was found in the other 4, necessitating reoperation in two. Group B consisted of 11 patients with small ulcer, scar and/or aphthoid ulcer, and Group C 6 patients without residual lesions. Eight patients in Group B and two in Group C developed suture line recurrence, and two patients required reoperation in Group B, but none in Group C. From these results, we concluded that reoperation was recessitated by suture line recurrence, irrespective of residual lesions.
日本大腸肛門病学会の論文