Dipartimento e Cattedra di Chirurgia Generale, Istituto Clinico Humanitas IRCCS, Università degli Studi di Milano, Rozzano, Milano, Italy.
Gastroenterol Res Pract. 2012;2012:381017. doi: 10.1155/2012/381017. Epub 2012 Jan 2.
In spite of the recent improvements in drug therapy, surgery still represents the most frequent treatment for Crohn's disease (CD) complications. Laparoscopy has been widely applied over the last twenty years in colorectal surgery and was associated with lower postoperative pain, shorter hospitalization, faster return to daily activities, and better cosmetic results. Laparoscopy experienced a slower diffusion in inflammatory bowel disease surgery than in oncologic colorectal surgery, but proved to be safe and effective, and is currently considered the gold standard for the treatment of primary uncomplicated ileocolic CD. Indications for laparoscopy in CD have recently been widened to embrace more complicated or recurrent CD. This paper reviews the available data on the subset of recurrent CD patients. The reported results indicate that laparoscopy may be safely applied even in selected recurrent CD cases in hands of IBD surgeons with broad laparoscopic experience.
尽管药物治疗在最近取得了一些进展,但手术仍然是治疗克罗恩病(CD)并发症的最常见方法。腹腔镜技术在过去二十年中已广泛应用于结直肠外科手术中,其具有术后疼痛较轻、住院时间较短、更快恢复日常活动以及更好的美容效果等优势。与肿瘤结直肠手术相比,腹腔镜技术在炎症性肠病手术中的应用较为缓慢,但已被证明是安全有效的,目前被认为是治疗原发性单纯性回肠结肠 CD 的金标准。CD 的腹腔镜适应证最近已扩大到包括更复杂或复发性 CD。本文综述了复发性 CD 患者亚组的现有数据。报道的结果表明,在具有广泛腹腔镜经验的 IBD 外科医生手中,即使是在选择的复发性 CD 病例中,腹腔镜也可以安全应用。