The Role of Surgery in Crohn‘s Disease Treatment
Authors:
M. Huťan; M. Huťan ml.
Authors place of work:
IV. chirurgická klinika LF UKo a FNsP Bratislava, Slovenská republika, prednosta: doc. MUDr. Martin Huťan, CSc.
Published in the journal:
Rozhl. Chir., 2009, roč. 88, č. 4, s. 185-188.
Category:
Monothematic special - Original
Summary
Crohn‘s disease is a chronic, transmural inflammatory disease of the gastrointestinal tract of unknown origin. Even though surgical therapy may relieve symptoms in patients with complications, it still remains, together with medicamentous therapy, palliative. According to literature, cummulative probability of operation is 78% during 20 years.
Aim of study:
Analysis of experiences with surgical therapy of complications of Crohn’s disease and search for optimal method of surgical therapy.
Material and methods:
Authors present group of patients, that were treated on their clinic for complications of Crohn’s disease. In years 2006–2007 group consisted of 21 patients. Most common indications for hospitalisation were signs of perforative peritonitis and ileus, bleeding, fistulas and signs of acute appendicitis.
Results:
Following recommendations, resections of sick bowel dominated, we performed appendectomy once, bleeding was treated conservatively. Diagnosis was confirmed histologically from resected material or from biopsy. No patient died in the group, all of them were sent for next treatment to gastroenterology.
Conclusion:
Preferred therapy are classical surgical approaches to the acute abdomen, the spectrum of laparoscopical operations is widening, but their advantages may disappear in operations of large inflammatory tumours. It is necessary to consider alternative ways of treatment.
Key words:
Crohn’s disease – complications – surgical therapy
Zdroje
1. Alexander–Williams, J., Haynes, I. G. Conservative operations for Crohns disease of the small bowel. W. J. Surg., 9, 1985, č. 6, s. 645–651.
2. Cameron, J. L. Crohns disease . Current Surgical Therapy. 8th Edition, Elsevier – Mosby, Philadelphia, 2004, 1344 s.
3. Casillas, S., Delaney, C. P. Laparoscopic surgery for inflammatory bowel disease. Dig. Surg., 22, 2005, č. 3, s. 135–142.
4. Fazio, V. W., Marchetti, F., Church, M., Goldblum, J. R., Lavery, C., Hull, T. L., Milsom, J. W., Strong, S. A., Oakley, J., Secic, M. Effect of resection margins on the recurrence of Crohns disease in the small bowell. A randomised controlled trial. Ann. Surg., 224, 1996, č. 4, s. 563–571.
5. Gardiner, K. R., Dasari, B. V. M.: Operative Management of Small Bowell Crohns Disease. Surg. Clin. N. Amer., 87, 2007, č. 3, s. 587–610.
6. Hamilton, S. R., Reese, J., Pennington, L. The role of resection margin frozen section in the surgical management of Crohns disease. Surg. Gynecol. Obstet., 160, 1985, s. 57–62.
7. Munoz–Juarez, M., Yamamoto, T., Wolff, B. G., Heighley, M. R. B. Wide-lumen stapled anastomosis v.s. conventional end-to-end anastomosis in the treatment of Crohns disease. Dis. Colon Rectum, 44, 2001, s. 20–26.
8. Present, D. H., Rutgeerts, P., Targan, S., Hananer, S. B., Mayer, L., van Hogezand, R. A., Podolsky, D. K., Sands, B. E., Braakman, T., De Woody, K. L., Schaible, T. F., van Deventer, S. J. Infliximab for the treatment of fistulas in patients with Crohn‘s disease. N. Engl. J. Med., 340, 1999, č. 18, s. 1398–1405.
9. Resegotti, A., Astegiano, M., Farina, E. C., Ciccone, G., Avagnina, G., Ginstetto, A., Campra, D., Fronda, G. R. Side-to-side stapled anastomosis strongly reduces anastomotic leak rates in Crohns disease surgery. Dis. Colon Rectum, 48, 2005, č. 3, s. 464–468.
10. Sabiston, D. C. Crohns disease. Textbook of Surgery. W. B. Saunders Company, Philadelphia, 1997, 2318 s.
11. Tamboli, C. P. Current Medical Therapy for Chronic Inflammatory Bowel Diseases. Surg. Clin. N. Amer., 87, 2007, č. 3, s. 697–725.
12. Tilney, H. S., Constantinides, V. A., Heriot, A. G., Nicolaou, M., Athanasiou, T., Ziprin, P., Darzi, A. W., Tekkis, P. P. Comparison of laparoscopic and open ileocecal resection for Crohns disease: a metaanalysis. Surg. Endosc., 20, 2006, s. 1036–1044.
Štítky
Surgery Orthopaedics Trauma surgeryČlánok vyšiel v časopise
Perspectives in Surgery
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