The Influence of Microscopic Disease at the Margin of Resection on Recurrence Rates in Crohn's Disease

Overview

Journal Ann R Coll Surg Engl

Specialty General Surgery

Date 1986 Jan 1

PMID 3947011

Citations 7

Authors

J C Cooper

N S Williams

Affiliations

Soon will be listed here.

Abstract

One hundred and forty-two patients with Crohn's disease, undergoing 154 resections and reanastomoses, were reviewed to evaluate the influence of residual microscopic Crohn's disease at the margin of resection on recurrence. Sixty-three cases had microscopic evidence of disease at the resection margin (group I), and 91 cases had disease-free margins (group II). Of the survivors 125 patients undergoing 136 operations were reviewed. Median follow-up was 6.0 years (range 0.25-16 years) in group I, and 5.5 years (range 0.25-14.5 years) in group II. Twenty-two of 57 cases (38%) in group I developed recurrence compared with 23 of 79 cases (29%) in group II (P-NS). Cumulative recurrence rates at 10 years were 66.5% and 58% respectively (P-NS). The results support the increasing evidence that the presence of microscopic disease at the resection margin does not adversely affect recurrence in Crohn's disease.

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References

Pennington L, Hamilton S, Bayless T, Cameron J . Surgical management of Crohn's disease. Influence of disease at margin of resection. Ann Surg. 1980; 192(3):311-8. PMC: 1344907. DOI: 10.1097/00000658-198009000-00006. View

Farmer R . Clinical features and natural history of inflammatory bowel disease. Med Clin North Am. 1980; 64(6):1103-15. DOI: 10.1016/s0025-7125(16)31558-9. View

Fasth S, Hellberg R, Hulten L, Magnusson O . Early complications after surgical treatment for Crohn's disease with particular reference to factors affecting their development. Acta Chir Scand. 1980; 146(7):519-26. View

Karesen R, Thoresen B, Hertzberg J . Crohn's disease: long-term results of surgical treatment. Scand J Gastroenterol. 1981; 16(1):57-64. View

Lee E, Papaioannou N . Minimal surgery for chronic obstruction in patients with extensive or universal Crohn's disease. Ann R Coll Surg Engl. 1982; 64(4):229-33. PMC: 2494172. View

Irving M . Assessment and management of external fistulas in Crohn's disease. Br J Surg. 1983; 70(4):233-6. DOI: 10.1002/bjs.1800700416. View

Wolff B, Beart Jr R, Frydenberg H, Weiland L, Agrez M, Ilstrup D . The importance of disease-free margins in resections for Crohn's disease. Dis Colon Rectum. 1983; 26(4):239-43. DOI: 10.1007/BF02562486. View

Heuman R, BOERYD B, Bolin T, Sjodahl R . The influence of disease at the margin of resection on the outcome of Crohn's disease. Br J Surg. 1983; 70(9):519-21. DOI: 10.1002/bjs.1800700904. View

Baker W . Ileo-rectal anastomosis for Crohn's disease of the colon. Gut. 1971; 12(6):427-31. PMC: 1411671. DOI: 10.1136/gut.12.6.427. View

10.

Burman J, COOKE W, Williams J . The fate of ileorectal anastomosis in Crohn's disease. Gut. 1971; 12(6):432-6. PMC: 1411665. DOI: 10.1136/gut.12.6.432. View

11.

Williams J . The place of surgery in Crohn's disease. Gut. 1971; 12(9):739-49. PMC: 1411802. DOI: 10.1136/gut.12.9.739. View

12.

Kyle J . Surgical treatment of Crohn's disease of the small intestine. Br J Surg. 1972; 59(10):821-3. DOI: 10.1002/bjs.1800591020. View

13.

Colcock B . Operative technique in surgery for Crohn's disease and its relationship to recurrence. Surg Clin North Am. 1973; 53(2):375-80. DOI: 10.1016/s0039-6109(16)39991-1. View

14.

Lee E, Desu M . A computer program for comparing K samples with right-censored data. Comput Programs Biomed. 1972; 2(4):315-21. DOI: 10.1016/0010-468x(72)90019-0. View

15.

GOODMAN M, Skinner J, TRUELOVE S . Abnormalities in the apparently normal bowel mucosa in Crohn's disease. Lancet. 1976; 1(7954):275-8. DOI: 10.1016/s0140-6736(76)91404-5. View

16.

Weterman I, Pena A . The long-term prognosis of ileorectal anastomosis and proctocolectomy in Crohn's disease. Scand J Gastroenterol. 1976; 11(2):185-91. View

17.

Dunne W, COOKE W, Allan R . Enzymatic and morphometric evidence for Crohn's disease as a diffuse lesion of the gastrointestinal tract. Gut. 1977; 18(4):290-4. PMC: 1411456. DOI: 10.1136/gut.18.4.290. View

18.

Korelitz B, SOMMERS S . Rectal biopsy in patients with Crohn's disease. Normal mucosa on sigmoidoscopic examination. JAMA. 1977; 237(25):2742-4. View

19.

Stone W, VEIDENHEIMER M, Corman M, Coller J . The dilemma of Crohn's disease: long-term follow-up of Crohn's disease of the small intestine. Dis Colon Rectum. 1977; 20(5):372-6. DOI: 10.1007/BF02587362. View

20.

Bergman L, Krause U . Crohn's disease. A long-term study of the clinical course in 186 patients. Scand J Gastroenterol. 1977; 12(8):937-44. DOI: 10.3109/00365527709181353. View