Introduction. Essential increase of Crohn’s disease (CD) incidence and changes of disease evolution were marked in some countries of Eastern Europe. Studies in the Republic of Moldova are insufficient. Aim of the study. To analyze the clinical features, evolution and surgical treatment of CD in Moldova in the last 3 years. Material and methods. The demographic, clinical and biological parameters were analyzed in retrospective study in patients with CD from surgical department of Republican Clinical Hospital in 2015-2017. Diagnosis of CD was confirmed by endoscopy, histology, radiology or entero-MRI. Results. The study included 44 patients aged 17-75 years, mean age - 45,1±14,7. The predominance of male (59.1%), patients from urban areas (54.5%) and non-smokers (77.4%) were observed. The age at diagnosis between 17 and 40 years was in the majority of cases (54.5%), more than 40 years – 36.4% and less than 17 years – 9%. Disease location according to the Montreal classification was: 63.6% - ileocolon; 31.8% - colon; 4.6% - terminal ileum. Disease behavior of B1 type (non-stricturing non-penetrating) was detected in 4.6% cases; of type B2 (stricturing) - in 36.4% cases; of type B3 (penetrating) - in 40.9% and 18.1% of patients had stricturing and penetrating course. The urgent surgical intervention was done in 52.3% of cases, and the elective surgery in 47.7%. The main indication for urgent surgery were intestinal occlusion, acute hemorrhage and local septic complication; for elective surgery – fistula, sub compensated stenosis and ineffectiveness of medical treatment. The percentage of post-surgical replaces and repeated surgical intervention had a direct correlation with the disease duration: in case of CD duration less than 5 years 29.4% underwent repeated surgery, in case of disease evolution longer than 10 years – 58.3%. The most often type of surgical intervention was the hemicolectomy with ileotransverse anastomosis (38.6%), and subtotal colectomy with ileorecto anastomosis (25%). Fistula excision, abscess treatment with or without segmental resection of intestine was done in 25% of patients. Subtotal colectomy with ileostoma was necessary in 11.4%. Conclusions. The major part of patients with CD from surgical department had progressive structuring and / or penetrating disease evolution (95.4%). The most often type of surgical intervention was the hemicolectomy with ileotransverse anastomosis (38.6%). The percentage of post-surgical replaces and repeated surgical intervention had a direct correlation with the disease duration.

Introduction. Essential increase of Crohn’s disease (CD) incidence and changes of disease evolution were marked in some countries of Eastern Europe. Studies in the Republic of Moldova are insufficient. Aim of the study. To analyze the clinical features, evolution and surgical treatment of CD in Moldova in the last 3 years. Material and methods. The demographic, clinical and biological parameters were analyzed in retrospective study in patients with CD from surgical department of Republican Clinical Hospital in 2015-2017. Diagnosis of CD was confirmed by endoscopy, histology, radiology or entero-MRI. Results. The study included 44 patients aged 17-75 years, mean age - 45,1±14,7. The predominance of male (59.1%), patients from urban areas (54.5%) and non-smokers (77.4%) were observed. The age at diagnosis between 17 and 40 years was in the majority of cases (54.5%), more than 40 years – 36.4% and less than 17 years – 9%. Disease location according to the Montreal classification was: 63.6% - ileocolon; 31.8% - colon; 4.6% - terminal ileum. Disease behavior of B1 type (non-stricturing non-penetrating) was detected in 4.6% cases; of type B2 (stricturing) - in 36.4% cases; of type B3 (penetrating) - in 40.9% and 18.1% of patients had stricturing and penetrating course. The urgent surgical intervention was done in 52.3% of cases, and the elective surgery in 47.7%. The main indication for urgent surgery were intestinal occlusion, acute hemorrhage and local septic complication; for elective surgery – fistula, sub compensated stenosis and ineffectiveness of medical treatment. The percentage of post-surgical replaces and repeated surgical intervention had a direct correlation with the disease duration: in case of CD duration less than 5 years 29.4% underwent repeated surgery, in case of disease evolution longer than 10 years – 58.3%. The most often type of surgical intervention was the hemicolectomy with ileotransverse anastomosis (38.6%), and subtotal colectomy with ileorecto anastomosis (25%). Fistula excision, abscess treatment with or without segmental resection of intestine was done in 25% of patients. Subtotal colectomy with ileostoma was necessary in 11.4%. Conclusions. The major part of patients with CD from surgical department had progressive structuring and / or penetrating disease evolution (95.4%). The most often type of surgical intervention was the hemicolectomy with ileotransverse anastomosis (38.6%). The percentage of post-surgical replaces and repeated surgical intervention had a direct correlation with the disease duration.