Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejada

Background: Exclusive involvement of the colon or rectum in Crohn's disease, called Crohn's colitis, (CC) occurs in about 25% of these patients. Aim: To analyze early surgical results and long-term outcomes of patients undergoing surgery for CC. Material and Methods: Review of a prospec...

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Autores principales:	Imigo G.,Felipe, Molina P.,María-Elena, Álvarez-Lobos,Manuel, Quintana V.,Carlos, Klaassen L.,Julieta, Torres M.,Javiera, Duarte G.,Ignacio, Bellolio R.,Felipe, Zúñiga D.,Álvaro
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2018
Materias:	Colitis Colorectal Surgery Crohn Disease
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000200183
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spelling	oai:scielo:S0034-988720180002001832018-06-20Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejadaImigo G.,FelipeMolina P.,María-ElenaÁlvarez-Lobos,ManuelQuintana V.,CarlosKlaassen L.,JulietaTorres M.,JavieraDuarte G.,IgnacioBellolio R.,FelipeZúñiga D.,Álvaro Colitis Colorectal Surgery Crohn Disease Background: Exclusive involvement of the colon or rectum in Crohn's disease, called Crohn's colitis, (CC) occurs in about 25% of these patients. Aim: To analyze early surgical results and long-term outcomes of patients undergoing surgery for CC. Material and Methods: Review of a prospective database, identifying patients with Crohn's disease operated between 2003 and 2015 and excluding those with ileocecal disease. We analyzed demographic data, pre and postoperative pharmacological treatment, operations, morbidity and the need for a second bowel resection at follow-up. Results: We reviewed data from 28 patients aged 17 to 72 years (15 men). Twenty-seven (96.4%) had previous pharmacological treatment, 11 received monoclonal antibodies. The most common indications for surgical treatment were failure of medical treatment in 15 cases, acute severe colitis in 12 and anemia/malnutrition in eight. Total colectomy was performed in 17 (61%) patients, proctocolectomy in 8 (29%) and segmental colectomies in 3 (11%). Sixteen (57%) were operated laparoscopically. Major postoperative complications were observed in 5 (18%). Four needed a reintervention. There was no operative mortality. During a 55 months median follow-up of 27 patients, seven (26%) required a second bowel resection, one of them for recurrence. Nineteen (70%) patients had an ostomy, which was permanent in 11. Fifteen patients are without medical treatment. Conclusions: Most of the reviewed patients required total colectomy for the control of the disease with a low surgical morbidity. Two-thirds required an ileostomy, which became permanent in half of them.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.146 n.2 20182018-02-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000200183es10.4067/s0034-98872018000200183
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Colitis Colorectal Surgery Crohn Disease
spellingShingle	Colitis Colorectal Surgery Crohn Disease Imigo G.,Felipe Molina P.,María-Elena Álvarez-Lobos,Manuel Quintana V.,Carlos Klaassen L.,Julieta Torres M.,Javiera Duarte G.,Ignacio Bellolio R.,Felipe Zúñiga D.,Álvaro Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejada
description	Background: Exclusive involvement of the colon or rectum in Crohn's disease, called Crohn's colitis, (CC) occurs in about 25% of these patients. Aim: To analyze early surgical results and long-term outcomes of patients undergoing surgery for CC. Material and Methods: Review of a prospective database, identifying patients with Crohn's disease operated between 2003 and 2015 and excluding those with ileocecal disease. We analyzed demographic data, pre and postoperative pharmacological treatment, operations, morbidity and the need for a second bowel resection at follow-up. Results: We reviewed data from 28 patients aged 17 to 72 years (15 men). Twenty-seven (96.4%) had previous pharmacological treatment, 11 received monoclonal antibodies. The most common indications for surgical treatment were failure of medical treatment in 15 cases, acute severe colitis in 12 and anemia/malnutrition in eight. Total colectomy was performed in 17 (61%) patients, proctocolectomy in 8 (29%) and segmental colectomies in 3 (11%). Sixteen (57%) were operated laparoscopically. Major postoperative complications were observed in 5 (18%). Four needed a reintervention. There was no operative mortality. During a 55 months median follow-up of 27 patients, seven (26%) required a second bowel resection, one of them for recurrence. Nineteen (70%) patients had an ostomy, which was permanent in 11. Fifteen patients are without medical treatment. Conclusions: Most of the reviewed patients required total colectomy for the control of the disease with a low surgical morbidity. Two-thirds required an ileostomy, which became permanent in half of them.
author	Imigo G.,Felipe Molina P.,María-Elena Álvarez-Lobos,Manuel Quintana V.,Carlos Klaassen L.,Julieta Torres M.,Javiera Duarte G.,Ignacio Bellolio R.,Felipe Zúñiga D.,Álvaro
author_facet	Imigo G.,Felipe Molina P.,María-Elena Álvarez-Lobos,Manuel Quintana V.,Carlos Klaassen L.,Julieta Torres M.,Javiera Duarte G.,Ignacio Bellolio R.,Felipe Zúñiga D.,Álvaro
author_sort	Imigo G.,Felipe
title	Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejada
title_short	Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejada
title_full	Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejada
title_fullStr	Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejada
title_full_unstemmed	Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejada
title_sort	colitis de crohn: resultados del tratamiento quirúrgico y evolución alejada
publisher	Sociedad Médica de Santiago
publishDate	2018
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000200183
work_keys_str_mv	AT imigogfelipe colitisdecrohnresultadosdeltratamientoquirurgicoyevolucionalejada AT molinapmariaelena colitisdecrohnresultadosdeltratamientoquirurgicoyevolucionalejada AT alvarezlobosmanuel colitisdecrohnresultadosdeltratamientoquirurgicoyevolucionalejada AT quintanavcarlos colitisdecrohnresultadosdeltratamientoquirurgicoyevolucionalejada AT klaassenljulieta colitisdecrohnresultadosdeltratamientoquirurgicoyevolucionalejada AT torresmjaviera colitisdecrohnresultadosdeltratamientoquirurgicoyevolucionalejada AT duartegignacio colitisdecrohnresultadosdeltratamientoquirurgicoyevolucionalejada AT belloliorfelipe colitisdecrohnresultadosdeltratamientoquirurgicoyevolucionalejada AT zunigadalvaro colitisdecrohnresultadosdeltratamientoquirurgicoyevolucionalejada
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Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejada

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