Surgical management of Crohn's disease

Langenbecks Arch Surg. 2013 Jan;398(1):13-27. doi: 10.1007/s00423-012-0919-7. Epub 2012 Feb 21.

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.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Abdominal Abscess / diagnosis
  • Abdominal Abscess / surgery
  • Adolescent
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Child
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Constriction, Pathologic / surgery
  • Crohn Disease / complications
  • Crohn Disease / diagnosis
  • Crohn Disease / surgery*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infliximab
  • Intestinal Fistula / diagnosis
  • Intestinal Fistula / surgery
  • Intestine, Large / surgery
  • Intestine, Small / surgery
  • Laparoscopy / methods
  • Minimally Invasive Surgical Procedures / methods*
  • Postoperative Complications / prevention & control
  • Randomized Controlled Trials as Topic
  • Recurrence
  • Reoperation
  • Short Bowel Syndrome / prevention & control
  • Young Adult

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Monoclonal
  • Immunosuppressive Agents
  • Infliximab