Crohn's disease: long-term results of surgical treatment.

Fifty-nine patients operated on for Crohn's disease during the years 1954 to 1977 were studied. The observation time was from 1 to 24 years, mean 10 years. The operative mortality was 1.7%, and alter deaths from the disease and its complications 3.4%. The general state of health at the final follow-up observation was good for the large majority of the patients. Ony four patients (7%) had marked symptoms that affected the working capacity. Forty-four percent of the patients had one or more recurrences. The average yearly recurrence rate was 6.1% in the first 10 years of observation. In the next 10 years this rate diminished to 2.2%. The recurrence rates were much lower (14%) when the margins of the resected intestine were free of the disease than when microscopic signs of the disease were present (66%). To obtain a free margin, rather wide resection and peroperative frozen-section evaluation of resection margins are recommended. Eleven out of 12 patients with shunt operations had to be operated on again.