| International Session（Symposium）7(JSGS・JSGE・JGES) |
| Sat. November 23rd 10:00 - 12:00 Room 1: Kobe International Exhibition Hall No.2 Building Hall (North) |
| Clinical analysis of postoperative recurrence in initial intestinal resection with Crohn’s disease and treatment for prevention of recurrence | |||
| Akira Sugita1, Kazutaka Koganei1, Kenji Tatsumi1 | |||
| 1Department of Inflammatory Bowel Disease, Yokohama Municipal Citizens Hospital | |||
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| Purpose: The situation of postoperative recurrence and treatment for prevention of recurrence were analyzed in Crohn’s disease. Patients and method: 1) Of 1012 Crohn’s disease patients with initial intestinal resection, 975 patients excluding cancer patients were included (median follow up:91months). 2) The type of recurrence in the functional end to end anastomasis(FEE) with wide lumen was examined in 25 patients required reoperation for stricture. 3) The postoperative prophylactic effect of azathioprine was evaluated in 43 patients(median follow up: 24 months). Results:1) The postoperative reoperation for the recurrence in the anastomotic site or the other lesions was performed in 38% patients (366/975) including 45% patients(164/336) with recurrence in only anastomotic site. 2) Of 25 patients with FEE, stricture in anastomotic site was found in only 44%, stricture in the oral intestine adjacent to anastomotic site in 52%. 3) Nineteen percent of patients with azothioprine required additional treatment for recurrence Conclusion: The anastomotic recurrence was responsible for reoperation in only half of patients who needed reoperation after initial intestinal resection in Crohn’s disease. Functional end to end anastomosis was considered to have stricture proximal to the anastomosis as a recurrence. Azothioprine is considered to be one of the optimal treatment including economical aspect. |
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Index Term 1: Crohn's disease Index Term 2: Postoperative recurrence |
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