Surgical Management of Small Bowel Crohn's Disease

Chandrasinghe, Pramodh

doi:10.3389/fsurg.2022.759668

Cited by 6 publications

(4 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Long-term administration of metronidazole or ornidazole also has good results at the cost of some side effects, in a significant proportion of patients. Finally, penetrating disease requires a multidisciplinary approach with special attention to the nutritional rehabilitation of patients, the restoration of deficits, and skin care[ 7 ].…”

Section: Surgery For Small Bowel CDmentioning

confidence: 99%

Surgical treatment of inflammatory bowel disease: From the gastroenterologist’s stand-point

Triantafillidis

2024

World J Gastrointest Surg

View full text Add to dashboard Cite

Treatment of ulcerative colitis (UC) and Crohn’s disease (CD) represents, in the majority of cases, a real challenge to the gastroenterologist’s abilities and skills as well as a clinical test concerning his/her levels of medical knowledge and experience. During the last two decades, our pharmaceutical arsenal was significantly strengthened, especially after the introduction of the so-called biological agents, drugs which to a large extent not only improved the results of conservative treatment but also changed the natural history of the disease. However, colectomy is still necessary for some patients with severe UC although smaller compared to the past, precisely because of the improvements achieved in the available conservative treatment. Nevertheless, surgeries to treat colon dysplasia and cancer are increasing to some extent. At the same time, satisfactory improvements in surgical techniques, the pre-and post-operative care of patients, as well as the selection of the appropriate time for performing the surgery have been noticed. Regarding patients with CD, the improvement of conservative treatment did not significantly change the need for surgical treatment since two-thirds of patients need to undergo surgery at some point in the course of their disease. On the other hand, the outcome of the operation has improved through good preoperative care as well as the wide application of more conservative surgical techniques aimed at keeping as much of the bowel in situ as possible. This article discusses the indications for surgical management of UC patients from the gastroenterologist’s point of view, the results of the emerging new techniques such as transanal surgery and robotics, as well as alternative operations to the classic ileo-anal-pouch anastomosis. The author also discusses the basic principles of surgical management of patients with CD based on the results of the relevant literature. The self-evident is emphasized, that is, to achieve an excellent therapeutic result in patients with severe inflammatory bowel disease in today’s era; the close cooperation of gastroenterologists with surgeons, pathologists, imaging, and nutritionists is of paramount importance.

show abstract

Section: Surgery For Small Bowel CDmentioning

confidence: 99%

Surgical treatment of inflammatory bowel disease: From the gastroenterologist’s stand-point

Triantafillidis

2024

World J Gastrointest Surg

View full text Add to dashboard Cite

show abstract

“…The interplay between inflammatory cells, ECM, and the microbiota is implicated in stricture formation, and the mechanisms overlap between both types of strictures. Inflammatory strictures respond well to medical therapy, while fibrotic strictures require endoscopic or surgical intervention [28]. Different techniques for stricturoplasty have been described, depending on the length of the stricture, bowel diameter, and multifocality of the disease [29].…”

Section: Stricturoplastymentioning

confidence: 99%

“…Stricturoplasty has similar long-term outcomes to resection and is specifically recommended for multiple strictures, previous long-segment resections, early recurrences, short bowel syndrome, and malnutrition. In addition to conventional procedures, non-conventional stricturoplasties across the ileocecal valve have been performed with comparable outcomes [28].…”

Section: Annals Of Reviews and Researchmentioning

confidence: 99%

Surgical Management of Crohn’s Disease: An Overview

Gómez

2023

ARR

View full text Add to dashboard Cite

Crohn's Disease (CD) is a chronic inflammatory condition of the digestive tract resulting in symptoms such as abdominal pain, weight loss, and fatigue, requiring a multifaceted approach to management. While not curative, the surgical management of CD forms a vital part of the therapeutic strategy for complications. This article overviews various surgical methods for treating CD, their indications, and potential complications. CD predominantly emerges in developed countries, with known risk factors including genetic predisposition, environmental triggers, and diet. The clinical presentation involves varied symptoms based on the inflammation's location within the gastrointestinal tract. Diagnosis necessitates a comprehensive approach, including medical history, physical examination, and diagnostic tests. Surgical intervention may be necessary due to severe complications like intestinal obstruction, abscesses, strictures, fistulas, and perforation. Common reasons for surgery include medically resistant disease and malignancy. However, postoperative recurrence is frequent, necessitating repeated surgery in 26% of cases. This narrative review paper examines three major surgical interventions in detail. Fistulotomy, primarily used for simple fistulas, can offer symptomatic relief in well-selected CD cases but may risk complications and high recurrence rates. Stricturoplasty, useful for widening narrow bowels, preserves intestinal length and function and can serve as an effective alternative to resection. Lastly, the intestinal resection and colectomy procedures are explored, focusing on their indications and complications. Future research should focus on optimizing surgical approaches to reduce recurrence rates and improve patient outcomes.

show abstract

“…Strictureplasty is a recognized and safe surgical approach for small-bowel strictures of CD ( 41 ). Sampietro et al performed strictureplasty by laparoscopy and showed that it was both safe and feasible, resulting in a low rate of complications ( 42 ).…”

Section: The Application Of Minimally Invasive Techniquesmentioning

confidence: 99%

Minimally invasive surgery in Crohn’s disease: state-of-the-art review

Liu

Zhou

2023

Front. Surg.

View full text Add to dashboard Cite

Surgery for Crohn’s disease (CD) has undergone significant advancements over the last two decades, especially minimally invasive surgery. In addition to its feasibility and safety, minimally invasive surgery provides manifold advantages, including a decreased hospitalization duration, improved aesthetic results, and fewer occurrences of intra-abdominal adhesions. Due to the special intraoperative characteristics of CD, such as chronic inflammation, a thickened mesentery, ﬁstulas, abscesses and large masses, a minimally invasive approach seems to be challenging. Complete implementation of this technique for complex disease has yet to be studied. In this review, we provide a review on the applicability of minimally invasive surgery in CD and future perspectives for the technical advances in the field.

show abstract

Surgical Management of Small Bowel Crohn's Disease

Cited by 6 publications

References 71 publications

Surgical treatment of inflammatory bowel disease: From the gastroenterologist’s stand-point

Surgical treatment of inflammatory bowel disease: From the gastroenterologist’s stand-point

Surgical Management of Crohn’s Disease: An Overview

Minimally invasive surgery in Crohn’s disease: state-of-the-art review

Contact Info

Product

Resources

About