Abstract
To gain information on the pathogenesis of ileal recurrence, 86 patients with Crohn's disease undergoing their first ileocolic resection were randomized to receive either an end-to-end (n = 47) or side-to-end (n = 39) anastomosis. The demographic and clinical characteristics of both groups were similar. There were no statistically significant differences between the two groups in postoperative complications or in the subsequent development of symptomatic or documented recurrences. Among the 43 patients with follow-up in the end-to-end anastomosis group, there were 10 documented ileal recurrences (23%), and all involved distal ileum in the characteristic preanastomotic location. Among the 35 patients with follow-up in the side-to-end anastomosis group, there were 11 documented recurrences (31%, not significant). The ileal recurrence pattern could be determined accurately in five of these 11 patients and involved the ileum adjacent to the colon, but spared the distal ileum in the blind pouch. This study suggests that the fecal stream and reflux of colonic contents are important factors in determining the pattern of ileal recurrence after ileocolectomy for Crohn's disease.
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- Hamilton S. R., Reese J., Pennington L., Boitnott J. K., Bayless T. M., Cameron J. L. The role of resection margin frozen section in the surgical management of Crohn's disease. Surg Gynecol Obstet. 1985 Jan;160(1):57–62. [PubMed] [Google Scholar]
- Pennington L., Hamilton S. R., Bayless T. M., Cameron J. L. Surgical management of Crohn's disease. Influence of disease at margin of resection. Ann Surg. 1980 Sep;192(3):311–318. doi: 10.1097/00000658-198009000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rutgeerts P., Geboes K., Vantrappen G., Beyls J., Kerremans R., Hiele M. Predictability of the postoperative course of Crohn's disease. Gastroenterology. 1990 Oct;99(4):956–963. doi: 10.1016/0016-5085(90)90613-6. [DOI] [PubMed] [Google Scholar]
- Rutgeerts P., Goboes K., Peeters M., Hiele M., Penninckx F., Aerts R., Kerremans R., Vantrappen G. Effect of faecal stream diversion on recurrence of Crohn's disease in the neoterminal ileum. Lancet. 1991 Sep 28;338(8770):771–774. doi: 10.1016/0140-6736(91)90663-a. [DOI] [PubMed] [Google Scholar]
- Williams J. G., Wong W. D., Rothenberger D. A., Goldberg S. M. Recurrence of Crohn's disease after resection. Br J Surg. 1991 Jan;78(1):10–19. doi: 10.1002/bjs.1800780106. [DOI] [PubMed] [Google Scholar]