Roy P, Kumar D
Department of Colorectal Surgery, St George's Hospital, Blackshaw Road, London SW17 0QT, UK.
Br J Surg. 2004 Nov;91(11):1428-37. doi: 10.1002/bjs.4804.
Advances in the use of bowel-sparing surgery for Crohn's disease have led to the development of strictureplasty as an important technique to conserve small bowel length and reduce morbidity associated with malabsorption.
A literature review of long-term studies on strictureplasty was undertaken, and evidence of its safety and efficacy was evaluated.
The safety and efficacy of strictureplasty is confirmed in retrospective studies carried out over a period of 5-10 years, particularly when employed in patients at risk of short bowel syndrome, but certain questions regarding bowel function and disease activity after surgery remain unanswered. There is also concern that diseased tissue is left in situ after strictureplasty; this tissue has the potential for malignant transformation in the long term.
Strictureplasty has been used in surgery for Crohn's disease for the past 25 years. Studies have proven its efficacy in the treatment of carefully selected patients at risk of malabsorption owing to short bowel syndrome.
克罗恩病保留肠段手术的进展促使狭窄成形术得以发展,成为一项保留小肠长度并降低与吸收不良相关发病率的重要技术。
对有关狭窄成形术的长期研究进行文献综述,并评估其安全性和有效性的证据。
在长达5至10年的回顾性研究中证实了狭窄成形术的安全性和有效性,特别是在应用于短肠综合征风险患者时,但关于术后肠道功能和疾病活动的某些问题仍未得到解答。此外,有人担心狭窄成形术后病变组织会留在原位;从长远来看,这种组织有恶变的可能。
在过去25年中,狭窄成形术已用于克罗恩病的手术治疗。研究已证明其在治疗因短肠综合征而有吸收不良风险的精心挑选患者方面的有效性。