Surgical Management of Crohn's Disease

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2012 Feb 22

PMID 22350642

Citations 17

Authors

Virginia Oliva Shaffer

Steven D Wexner

Affiliations

Soon will be listed here.

Abstract

Introduction: Crohn's disease is an inflammatory bowel disease that can affect the entire gastrointestinal tract. It is chronic and incurable, and the mainstay of therapy is medical management with surgical intervention as complications arise. Surgery is required in approximately 70% of patients with Crohn's disease. Because repeat interventions are often needed, these patients may benefit from bowel-sparing techniques and minimally invasive approaches. Various bowel-sparing techniques, including strictureplasty, can be applied to reduce the risk of short-bowel syndrome.

Methods: A review of the available literature using the PubMed search engine was undertaken to compile data on the surgical treatment of Crohn's disease.

Results And Conclusion: Data support the use of laparoscopy in treating Crohn's disease, although the potential technical challenges in these settings mandate appropriate prerequisite surgical expertise.

Citing Articles

Comparison of Post-Operative Outcomes of Right Colectomy between Crohn's Disease and Adenocarcinoma of the Right Colon: A Retrospective Cohort Study.

Bursztyn N, Slomowitz E, Assaf D, Yahia E, Kent I, Wasserberg N J Clin Med. 2024; 13(10).

PMID: 38792351 PMC: 11122225. DOI: 10.3390/jcm13102809.

A BET Protein Inhibitor Targeting Mononuclear Myeloid Cells Affects Specific Inflammatory Mediators and Pathways in Crohn's Disease.

Elfiky A, Hageman I, Becker M, Verhoeff J, Li Yim A, Joustra V Cells. 2022; 11(18).

PMID: 36139421 PMC: 9497176. DOI: 10.3390/cells11182846.

Predictive Factors of Surgical Recurrence in Patients with Crohn's Disease on Long-Term Follow-Up: A Focus on Histology.

Caviglia G, Mineo C, Rosso C, Armandi A, Astegiano M, Canavese G J Clin Med. 2022; 11(17).

PMID: 36078973 PMC: 9457467. DOI: 10.3390/jcm11175043.

Intriguing Role of the Mesentery in Ileocolic Crohn's Disease.

Turri G, Carvello M, Ben David N, Spinelli A Clin Colon Rectal Surg. 2022; 35(4):321-327.

PMID: 35966976 PMC: 9365471. DOI: 10.1055/s-0042-1743590.

State-of-the-art surgery for Crohn's disease: Part II-colonic Crohn's disease and associated neoplasms.

MacLeod A, Kavalukas S, Scheurlen K, Galandiuk S Langenbecks Arch Surg. 2022; 407(7):2595-2605.

PMID: 35729401 DOI: 10.1007/s00423-022-02572-y.

References

Tan J, Tjandra J . Laparoscopic surgery for Crohn's disease: a meta-analysis. Dis Colon Rectum. 2007; 50(5):576-85. DOI: 10.1007/s10350-006-0855-0. View

Schlinkert R . Laparoscopic-assisted right hemicolectomy. Dis Colon Rectum. 1991; 34(11):1030-1. DOI: 10.1007/BF02049971. View

Tabet J, Hong D, Kim C, Wong J, Goodacre R, Anvari M . Laparoscopic versus open bowel resection for Crohn's disease. Can J Gastroenterol. 2001; 15(4):237-42. DOI: 10.1155/2001/814749. View

Mueller M, Geis M, Glatzle J, Kasparek M, Meile T, Jehle E . Risk of fecal diversion in complicated perianal Crohn's disease. J Gastrointest Surg. 2007; 11(4):529-37. PMC: 1852374. DOI: 10.1007/s11605-006-0029-3. View

Dasari B, McKay D, Gardiner K . Laparoscopic versus Open surgery for small bowel Crohn's disease. Cochrane Database Syst Rev. 2011; (1):CD006956. DOI: 10.1002/14651858.CD006956.pub2. View

Tonelli F, Ficari F . Strictureplasty in Crohn's disease: surgical option. Dis Colon Rectum. 2000; 43(7):920-6. DOI: 10.1007/BF02237351. View

Gillen C, Andrews H, Prior P, Allan R . Crohn's disease and colorectal cancer. Gut. 1994; 35(5):651-5. PMC: 1374750. DOI: 10.1136/gut.35.5.651. View

Soop M, Larson D, Malireddy K, Cima R, Young-Fadok T, Dozois E . Safety, feasibility, and short-term outcomes of laparoscopically assisted primary ileocolic resection for Crohn's disease. Surg Endosc. 2009; 23(8):1876-81. DOI: 10.1007/s00464-008-0308-z. View

Nguyen S, Teitelbaum E, Sabnis A, Bonaccorso A, Tabrizian P, Salky B . Laparoscopic resection for Crohn's disease: an experience with 335 cases. Surg Endosc. 2009; 23(10):2380-4. DOI: 10.1007/s00464-009-0362-1. View

10.

Thaler K, Dinnewitzer A, Oberwalder M, Weiss E, Nogueras J, Wexner S . Assessment of long-term quality of life after laparoscopic and open surgery for Crohn's disease. Colorectal Dis. 2005; 7(4):375-81. DOI: 10.1111/j.1463-1318.2005.00769.x. View

11.

Dietz D, Laureti S, Strong S, Hull T, Church J, Remzi F . Safety and longterm efficacy of strictureplasty in 314 patients with obstructing small bowel Crohn's disease. J Am Coll Surg. 2001; 192(3):330-7; discussion 337-8. DOI: 10.1016/s1072-7515(01)00775-x. View

12.

Galandiuk S, Kimberling J, Al-Mishlab T, Stromberg A . Perianal Crohn disease: predictors of need for permanent diversion. Ann Surg. 2005; 241(5):796-801. PMC: 1357134. DOI: 10.1097/01.sla.0000161030.25860.c1. View

13.

Sasaki I, Funayama Y, Naito H, Fukushima K, Shibata C, Matsuno S . Extended strictureplasty for multiple short skipped strictures of Crohn's disease. Dis Colon Rectum. 1996; 39(3):342-4. DOI: 10.1007/BF02049479. View

14.

Tilney H, Constantinides V, Heriot A, Nicolaou M, Athanasiou T, Ziprin P . Comparison of laparoscopic and open ileocecal resection for Crohn's disease: a metaanalysis. Surg Endosc. 2006; 20(7):1036-44. DOI: 10.1007/s00464-005-0500-3. View

15.

Nakajima K, Nezu R, Hirota M, Nishida T . The role of hand-assisted laparoscopic surgery in subtotal and total colectomy for Crohn's colitis. Surg Endosc. 2010; 24(11):2713-7. DOI: 10.1007/s00464-010-1031-0. View

16.

Alves A, Panis Y, Bouhnik Y, Marceau C, Rouach Y, Lavergne-Slove A . Factors that predict conversion in 69 consecutive patients undergoing laparoscopic ileocecal resection for Crohn's disease: a prospective study. Dis Colon Rectum. 2005; 48(12):2302-8. DOI: 10.1007/s10350-005-0190-x. View

17.

Holubar S, Dozois E, Privitera A, Cima R, Pemberton J, Young-Fadok T . Laparoscopic surgery for recurrent ileocolic Crohn's disease. Inflamm Bowel Dis. 2009; 16(8):1382-6. DOI: 10.1002/ibd.21186. View

18.

Kiran R, Nisar P, Church J, Fazio V . The role of primary surgical procedure in maintaining intestinal continuity for patients with Crohn's colitis. Ann Surg. 2011; 253(6):1130-5. DOI: 10.1097/SLA.0b013e318212b1a4. View

19.

Biancone L, Sica G, Calabrese E, Onali S, Petruzziello C, Pallone F . Frequency and pattern of endoscopic recurrence in Crohn's disease patients with ileocolonic resection using a laparoscopic versus laparotomic approach: a prospective longitudinal study. Am J Gastroenterol. 2008; 103(3):809-11. DOI: 10.1111/j.1572-0241.2007.01612_14.x. View

20.

Kawahara H, Watanabe K, Ushigome T, Noaki R, Kobayashi S, Yanaga K . Single-incision laparoscopic right colectomy for recurrent Crohn's disease. Hepatogastroenterology. 2011; 57(102-103):1170-2. View