Segmental resection or subtotal colectomy in Crohn's colitis?
2002 (English)In: Diseases of the Colon & Rectum, ISSN 0012-3706, E-ISSN 1530-0358, Vol. 45, no 1, 47-53 p.Article in journal (Refereed) Published
PURPOSE: Segmental resection for Crohn's colitis is controversial. Compared with subtotal colectomy, segmental resection is reported to be associated with a higher rate of re-resection. Few studies address this issue, and postoperative functional outcome has not been reported previously. This study compared segmental resection to subtotal colectomy with anastomosis with regard to re-resection, postoperative symptoms, and anorectal function.
METHODS: Fifty-seven patients operated on between 1970 and 1997 with segmental resection (n = 31) or subtotal colectomy (n = 26) were included. Reoperative procedures were analyzed by a life-table technique. Segmentally resected patients were also compared separately with a subgroup of subtotally colectomized patients (n = 12) with similarly limited colonic involvement. Symptoms were assessed according to Best's modified Crohn's Disease Activity Index and an anorectal function score.
RESULTS: The re-resection rate did not differ between groups in either the entire study population (P = 0.46) or the subgroup of patients with comparable colonic involvement (P = 0.78). Segmentally resected patients had fewer symptoms (P = 0.039), fewer loose stools (P = 0.002), and better anorectal function (P = 0.027). Multivariate analysis revealed the number of colonic segments removed to be the strongest predictive factor for postoperative symptoms and anorectal function (P = 0.026 and P = 0.013, respectively).
CONCLUSION: Segmental resection should be considered in limited Crohn's colitis.
Place, publisher, year, edition, pages
2002. Vol. 45, no 1, 47-53 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-24878DOI: 10.1007/s10350-004-6113-4Local ID: 9280OAI: oai:DiVA.org:liu-24878DiVA: diva2:245201