Karoui Sami, Kallel Lamia, Boubaker Jalel, Filali Azza
Service de Gastro-entérologie A. Hôpital la Rabra, Tunis.
Tunis Med. 2006 Oct;84(10):595-8.
Postoperative recurrences art frequent in Crohn's disease. Early recurrent lesions in the neoterminal ileum after ileocoIonic anastomosis is the most important risk factor for symptomatic recurrence of Crohn's disease after curative surgical resection. Others risk factors are ileocolonic anastomosis, perforating indication of surgery and smoking status. Many drugs have been evaluated for the prevention of clinical postoperative recurrence: Antibiotics, particularly metronidazole ornidazole, and a little benefice of mesalamine. Azathioprine and 6 mercaptopurine have been recently evaluated; with a not clear clinical effect for prevention of clinical recurrence after resection in Crohn's disease. Several authors have proposed an empiric strategy for the prevention of recurrence after curative resection, based essentially on existence and severity of early endoscopic recurrence.
克罗恩病术后复发很常见。回结肠吻合术后新的末端回肠早期复发病变是根治性手术切除后克罗恩病症状性复发的最重要危险因素。其他危险因素包括回结肠吻合术、手术的穿孔指征和吸烟状况。许多药物已被评估用于预防临床术后复发:抗生素,特别是甲硝唑或奥硝唑,以及美沙拉嗪有一点益处。硫唑嘌呤和6-巯基嘌呤最近也进行了评估;对预防克罗恩病切除术后的临床复发,其临床效果尚不清楚。几位作者提出了一种根治性切除术后预防复发的经验性策略,主要基于早期内镜复发的存在和严重程度。