Am J Surg  2000 Apr;179(4):266-70 

Long-term results and multivariate analysis of prognostic factors in 138

consecutive patients operated on for Crohn's disease using "bowel-sparing"

techniques.

Cristaldi M, Sampietro GM, Danelli PG, Bollani S, Bianchi Porro G, Taschieri AM.

Division of General Surgery, Universita degli Studi di Milano, Istituto di

Scienze Biomediche, Ospedale Luigi Sacco, Milan, Italy.

BACKGROUND: Conservative surgery has become accepted as a useful option for the

surgical treatment of complicated Crohn's disease (CD). METHODS: One hundred

thirty-eight consecutive patients treated with strictureplasty or miniresections

for complicated CD have been observed prospectively. The possible influence of a

number of variables on the risk of recurrence was investigated using the Cox

proportional hazard model, and a time-to-event analysis was made using the

Kaplan-Meier function. RESULTS: There was no perioperative mortality; the

morbidity rate was 5.7%. A close correlation was found between the risk of

recurrence and the time between diagnosis and first surgery. The overall 5-year

recurrence rate was 24%, being 36% in the patients requiring surgery within 1

year of diagnosis and 14% in those operated on more than 1 year after diagnosis.

CONCLUSIONS: Risk factor analysis highlighted a group of patients at high risk

of surgical recurrence. Given that our results are similar to those reported in

other series, we consider strictureplasty and miniresections safe and effective

procedures for the treatment of complicated CD.