Tjandra J J, Fazio V W
Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio 44195.
Int Surg. 1992 Jan-Mar;77(1):9-14.
The majority of patients with Crohn's colitis eventually require surgical excision of the disease. The decision as to which operation to perform depends on the extent and site of disease, distensibility of the rectum, the presence of perianal disease, the age and attitude of the patients and their acceptance or otherwise of a stoma. Total proctocolectomy and ileostomy gave the best long-term results for Crohn's colitis in terms of recurrence rate. Abdominal colectomy and ileorectal anastomosis often restores young patients to good health without the risk of impaired sexual function from pelvic dissection and a permanent stoma is delayed and sometimes avoided. Segmental colonic resection should be considered for isolated short segment of Crohn's colitis but the optimal timing of such a procedure is not clear.
大多数克罗恩病性结肠炎患者最终需要手术切除病变部位。决定实施何种手术取决于疾病的范围和部位、直肠的扩张性、肛周疾病的存在情况、患者的年龄和态度以及他们对造口的接受与否。就复发率而言，全直肠结肠切除术和回肠造口术对克罗恩病性结肠炎的长期效果最佳。腹部结肠切除术和回肠直肠吻合术通常能使年轻患者恢复健康，且无盆腔解剖导致性功能受损的风险，永久性造口可延迟进行，有时甚至可避免。对于孤立的短段克罗恩病性结肠炎，应考虑行节段性结肠切除术，但该手术的最佳时机尚不清楚。
