크론병 환자의 수술 후 합병증과 재발
Postoperative Complications and Recurrence in Patients with Crohn’s Disease
홍동현, 유창식, 김대동, 김희철, 김진천, 정상훈, 최평화, 박인자,
소속 상세정보
홍동현 ( Hong Dong-Hyun )
울산대학교 의과대학 외과학교실
유창식 ( Yu Chang-Sik )
울산대학교 의과대학 외과학교실
김대동 ( Kim Dae-Dong )
울산대학교 의과대학 외과학교실
김희철 ( Kim Hee-Cheol )
울산대학교 의과대학 외과학교실
김진천 ( Kim Jin-Cheon )
울산대학교 의과대학 외과학교실
정상훈 ( Jung Sang-Hun )
울산대학교 의과대학 외과학교실
최평화 ( Choi Pyong-Wha )
울산대학교 의과대학 외과학교실
박인자 ( Park In-Ja )
울산대학교 의과대학 외과학교실
KMID : 0356720080240010013
Abstract
Purpose: This study was performed to assess postoperative complications and recurrence rates and to elucidate the risk factors in Crohn’s disease (CD).
Methods: A retrospective review was undertaken for patients who had undergone bowel surgery at Asan Medical Center between October 1991 and June 2006. Symptomatic recurrence was defined as the presence of symptoms related to CD that was subsequently verified by radiologic or endoscopic finding. Surgical recurrence was defined as the need for repeated surgery for enteric CD.
Results: There were 160 patients with a mean follow up of 34 months (108 men and 52 women; mean age: 29.7±10.9). The most common indication for surgery was a complication of CD, such as intra-abdominal abscess (31.9%), intestinal obstruction (21.9%), and internal fistula (19.4%). Another frequent indication was medical intractability (23.8%). The types of surgical procedures were ileocolic resection (50.0%), small bowel resection (25.0%), total/subtotal colectomy (17.5%), and others. The cumulative symptomatic recurrences were 15.9% and 36.4% at 2 and 5 years, and the cumulative surgical recurrence was 13.6% at 5 years. The cumulative surgical recurrence was higher for stricturing-type CD than for penetrating-type CD (P=0.049). No other significant risk factor for recurrence was found in our study. Twenty patients (12.5%) had postoperative complications, such as intra-abdominal abscess, anastomosis leakage, obstruction, and wound infection.
Conclusions: The postoperative complication and recurrence rates were acceptable. For stricturing-type Crohn’s disease surgical recurrence is higher than penetrating type, but long-term follow up is needed to verify the risk factors for recurrence. J Korean Soc Coloproctol 2008;24: 13-19
키워드
크론병;수술 후 재발;합병증
Crohn’s disease;Postoperative recurrence;Complications
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