M Hut'an1, M ml Hut'an. 1. IV chirurgická klinika LF UKo a FNsP Bratislava, Slovenská republika. martin.hutan@nspr.sk
Abstract
UNLABELLED: Crohn's disease is a chronic, transmural inflammatory disease of the gastrointestinal tract of unknown origin. Even though surgical therapy may relieve symptoms in patients with complications, it still remains, together with medicamentous therapy, palliative. According to literature, cummulative probability of operation is 78% during 20 years. AIM OF STUDY: Analysis of experiences with surgical therapy of complications of Crohn's disease and search for optimal method of surgical therapy. MATERIAL AND METHODS: Authors present group of patients, that were treated on their clinic for complications of Crohn's disease. In years 2006-2007 group consisted of 21 patients. Most common indications for hospitalisation were signs of perforative peritonitis and ileus, bleeding, fistulas and signs of acute appendicitis. RESULTS: Following recommendations, resections of sick bowel dominated, we performed appendectomy once, bleeding was treated conservatively. Diagnosis was confirmed histologically from resected material or from biopsy. No patient died in the group, all of them were sent for next treatment to gastroenterology. CONCLUSION: Preferred therapy are classical surgical approaches to the acute abdomen, the spectrum of laparoscopical operations is widening, but their advantages may disappear in operations of large inflammatory tumours. It is necessary to consider alternative ways of treatment.
UNLABELLED: Crohn's disease is a chronic, transmural inflammatory disease of the gastrointestinal tract of unknown origin. Even though surgical therapy may relieve symptoms in patients with complications, it still remains, together with medicamentous therapy, palliative. According to literature, cummulative probability of operation is 78% during 20 years. AIM OF STUDY: Analysis of experiences with surgical therapy of complications of Crohn's disease and search for optimal method of surgical therapy. MATERIAL AND METHODS: Authors present group of patients, that were treated on their clinic for complications of Crohn's disease. In years 2006-2007 group consisted of 21 patients. Most common indications for hospitalisation were signs of perforative peritonitis and ileus, bleeding, fistulas and signs of acute appendicitis. RESULTS: Following recommendations, resections of sick bowel dominated, we performed appendectomy once, bleeding was treated conservatively. Diagnosis was confirmed histologically from resected material or from biopsy. No patient died in the group, all of them were sent for next treatment to gastroenterology. CONCLUSION: Preferred therapy are classical surgical approaches to the acute abdomen, the spectrum of laparoscopical operations is widening, but their advantages may disappear in operations of large inflammatory tumours. It is necessary to consider alternative ways of treatment.