Elective Procedures in Crohns Disease of the Colon

Throughout their lifespan, 70-80% of patients suffering form CD require surgical intervention. In 10-15 years from the first surgery, approximately 40-50% of patients require the next operation due to recurrence [20, 21].

Elective surgical strategy for Crohn's disease of the colon is somehow different from the strategy for CD of the small intestine. Due to the role of the small intestine, surgical procedures must aim to minimise the risk of "short bowel" syndrome. The large bowel is mainly responsible for the fluid-electrolyte balance. Surgical procedure performed in colonic Crohn's disease should minimise the risk of recurrence and also improve the quality of the patient's life [22]. Symptoms of colonic Crohn's disease depend on the location and extensiveness of pathological changes. Right colon and ileocecal involvement with concomitant obstruction require surgery in 90% of cases. Crohn's disease affecting the left colon requires surgical procedure in 60% of patients, and usually occurs in older patients. However, only 30% of patients with rectal CD require operation.

More than a half of the patients with Crohn's disease located in the left colon and rectum will require a stoma, but their quality of life remains good during the rest of life. More than 70% of those patients live just like before the onset of the disease [23].

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