Analysis Of Surgical Therapy For Crohn's Disease: A Report Of 25 Cases

Background: Crohn's Disease (CD) is a chronic relapsing inflammatory bowel disease. It can affect any part of the gastrointestinal (GI) tract, from the mouth to the anus. CD present with various type of manifestation, including obstruction, internal or external fistula, abdominal abscess, bleeding, and perforation. CD is generally considered a common disease in Europe and America and is traditionally considered a rare disease in China. However, the incidence of CD has been increasing in China in recent years significantly. While the pathogenesis of CD has only been partially understood, there is compelling evidence to suggest that interaction between environment factors and a genetic predisposition plays a significant role in the development of the disorder. Currently, neither medical therapy nor surgery can cure this chronic disease. Optimum management of CD patients requires an interactive partnership among gastroenterologist, surgeon and patient. It is estimated that approximately 80% of CD patients will require surgery at some point during their lifetime.On the condition of correct opportunity and proper operation type , surgical therapy can improve patients' life quality.Methods: 25 cases of CD with surgical therapy were gathered ,which were admitted during 2000.7 and 2010.9 for a retrospective study. The clinical data includ original data ,clinical manifestation, medical treatment, surgery indication, operation type and flow up the patients to observe the condition changed and prognosis.Results: Among 25 cases with Crohn disease, 8 cases were diagnosed before operation,and 17 cases(68%)were misdiagnosed.Main clinical manifestations included abdominal pain(84%), diarrhea(32%) and abdominal mass(16%)。Intestinal obstruction was the most common cause of the operation. Partial enterectomy andanastomosis was the main procedure. Postoperative complications occurred in 5cases, 7cases relapsedConclusion: The diagnostic rate of CD was low and the mis-diagnostic rate was high before the operation. Doctors can determine accurately this disease based on the findings during operation. When the patients with complications and medical treatment fails, surgical intervention is required, but doctors need to strictly control operation indication and the treatment is by selecting a reasonable method of operation and systemic medication.