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Analysis of results of surgical treatment in Crohn's disease.

BACKGROUND/AIMS
Crohn's disease is a non-specific, chronic inflammatory disorder affecting any part of alimentary tract. Patients receiving proper medication require surgery in 70-90% of cases. Analysis of results of surgical treatment in Crohn's disease in patients treated at the Medical University of Wrocław and an attempt to elaborate the optimal surgical strategy in Crohn's disease was the aim of the study.


METHODOLOGY
The medical documentation of 52 patients with confirmed diagnosis of Crohn's disease was analysed, focusing on the course of the disease before surgery linked with its localization, duration and medical treatment. Then indications for surgery, type of surgical procedure performed and perioperative morbidity and mortality were discussed.


RESULTS
Thirteen patients had urgent surgery. Thirty-nine patients had planned surgery. The most common procedure was ileocecal resection or right hemicolectomy. In 36 cases the postoperative course was uncomplicated. The most common surgical complication was wound infection. Pneumonia was the most common general complication. Fatal cases occured in elderly patients with long-term and severely complicated disease.


CONCLUSIONS
The optimal timing of surgery is extremely difficult and remains non-standardized. Key decisions are often established intraoperatively and they require considerable surgeon experience, patient's awareness and close cooperation of surgeons and gastroenterologists.