BACKGROUND AND AIMS: This prospective study compared jejunoileal length in patients with Crohn's disease (CD) and the general population to determine whether this parameter can be related to outcome and management of CD complications. PATIENTS AND METHODS: Small bowel (SB) length was measured during abdominal surgery prior to bowel resection in 93 patients with CD and 92 patients without inflammatory or small bowel disease. RESULTS: SB length was shown to be shorter in patients with CD (462 vs. 567 cm) and was correlated to sex and height. There was no correlation of SB length to clinical expression (perforating or nonperforating), site, or outcome. SB length is not a prognosis factor of postoperative relapse. The presence of perineal disease and systemic abnormalities seem to be the only prognostic factors of surgical recurrence. Sex, age at onset, time of first surgery, site of disease, and mode of onset are not predictive of surgical recurrence. CONCLUSION: We recommend minimal intestinal resection when surgical treating CD complications in patients at high risk of surgical relapse and initial short SB. We advise using stricturoplasty or leaving asymptomatic intestinal lesions to reduce short bowel syndrome occurrence when performing iterative surgery.
BACKGROUND AND AIMS: This prospective study compared jejunoileal length in patients with Crohn's disease (CD) and the general population to determine whether this parameter can be related to outcome and management of CD complications. PATIENTS AND METHODS: Small bowel (SB) length was measured during abdominal surgery prior to bowel resection in 93 patients with CD and 92 patients without inflammatory or small bowel disease. RESULTS: SB length was shown to be shorter in patients with CD (462 vs. 567 cm) and was correlated to sex and height. There was no correlation of SB length to clinical expression (perforating or nonperforating), site, or outcome. SB length is not a prognosis factor of postoperative relapse. The presence of perineal disease and systemic abnormalities seem to be the only prognostic factors of surgical recurrence. Sex, age at onset, time of first surgery, site of disease, and mode of onset are not predictive of surgical recurrence. CONCLUSION: We recommend minimal intestinal resection when surgical treating CD complications in patients at high risk of surgical relapse and initial short SB. We advise using stricturoplasty or leaving asymptomatic intestinal lesions to reduce short bowel syndrome occurrence when performing iterative surgery.
Authors: D B Sachar; K Subramani; K Mauer; S Rivera-MacMurray; P Turtel; C A Bodian; A J Greenstein Journal: J Clin Gastroenterol Date: 1996-03 Impact factor: 3.062