Colonic Crohn’s disease-decision is more important than incision:A surgical dilemma

• 作者: Giuseppe Brisinda Maria Cariati Maria Michela Chiarello
• 来源期刊: 世界胃肠外科杂志:英文版(电子版)
• 学科: 医学
• 关键词: Crohn’s disease Colonic Crohn’s disease Surgery Surgical treatment Colonic resection Segmental colectomy Total colectomy
• 年，卷（期）: 2021,（1）
• 页码范围: 1-6
• 页数: 6页
• 分类号: R57

摘要

The most common localization for intestinal Crohn’s disease(CD)is the terminal ileum and ileocecal area.It is estimated that patients with CD have one in four chance of undergoing surgery during their life.As surgery in ulcerative colitis ultimately cures the disease,in CD,regardless of the extent of bowel removed,the risk of disease recurrence is as high as 40%.In elective surgery,management of isolated Crohn’s colitis continues to evolve.Depending on the type of surgery performed,colonic CD patients often require further medical or surgical therapy to prevent or treat recurrence.The elective surgical treatment of colonic CD is strictly dependent on the localization of disease,and the choice of the procedure is dependent of the extent of colonic involvement and previous resection.The most common surgical options in colonic CD are total proctocolectomy(TPC)with permanent ileostomy,segmental bowel resection,subtotal colectomy.TPC completely removes all colonic and rectal disease and avoids the use of a potentially diseased anus.We will review current options for the elective surgical treatment of colonic CD,based on the current literature and our own personal experience.