대한대장항문학회

We have performed a retrospective analysis of 42 patients with Crohn's disease<br>operated at the Department of Surgery, Seoul National University College of Medicine<br>between 1978 and 1997. The most frequently involved site was ileocecum(40.5%) and<br>small bowel(40.5%), whereas the large bowel and anorectum occupied only 2.4% and<br>7.1% rutspectively. In 39 patients with bowel involvement, 35 patients(90%) required<br>resection as primary surgical operations(small bowel 18, right colon 11, ileocecum 6).<br>The remaining 7 patients underwent intaabdominal abscess drainage(2), perianal abscess<br>drainage(2), appendectomy(1), and exploration only(1). Two cases of small bowel<br>resection were combined with multiple stricturoplasties. After mean follow-up period of<br>46 months(range 1∼180, median 22 months) after primary operation, the cumulative<br>reoperative recurrence rate was 25% at 3 years,47% at 5 years, and 79% at 10 years,<br>respectively. The ileocecal type had higher cumulative reoperative recurrence rate than<br>small bowel type(50% compared to 34% at 5 years). The age at symptom onset, age at<br>time of first operation, duration between symptom onset and operation, and the<br>indication for operation had no effect on reoperative recurrence rate. Despite short<br>follow-up period and limited number of patients, our results confirmed that Crohn's<br>disease is associated with high rate of recurrence requiring re-operations.<br>