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Segmental Resection or Subtotal Colectomy in Crohn’s Colitis?

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

Abstract

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.

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    Authors
    1. P. Andersson M.D.
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    2. G. Olaison M.D., Ph.D.
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    3. O. Hallböök M.D., Ph.D.
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    4. R. Sjödahl M.D., Ph.D., F.R.C.S.
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    Andersson, P., Olaison, G., Hallböök, O. et al. Segmental Resection or Subtotal Colectomy in Crohn’s Colitis?. Dis Colon Rectum 45, 47–53 (2002). https://doi.org/10.1007/s10350-004-6113-4

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    • DOI: https://doi.org/10.1007/s10350-004-6113-4

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