Departments of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Department of Gastroenterology, Hôpital Saint-Louis, Paris, France.
Best Pract Res Clin Gastroenterol. 2014 Jun;28(3):497-503. doi: 10.1016/j.bpg.2014.04.013. Epub 2014 May 10.
Crohn's disease (CD) is a chronic and progressive disease characterized by the presence of inflammation in different segments of the digestive tract, resulting in damages of the entire wall. Untreated or treated inappropriately, this eventually might result in stricturing and/or penetrating complications. Traditionally, the first line of treatment is medical, and surgery reserved for those who failed medical therapy. Considerable progresses have been made in the surgical therapy of CD over the past two decades. Some surgical interventions such as those consisting in the resection of long segments or leading to a definitive stoma should be avoided and performed only in case of treatment failure. On the other side, well-indicated and minimal invasive surgery can be considered as an alternative to long-term medical therapy for certain indications. The decision of performing early surgery should take in account the strategy that will be applied post-operatively. Decision making in multidisciplinary teams is paramount.
克罗恩病（CD）是一种慢性、进行性疾病，其特征为消化道不同部位存在炎症，导致整个壁层受损。未经治疗或治疗不当，最终可能导致狭窄和/或穿透性并发症。传统上，一线治疗是医学治疗，手术仅保留给那些药物治疗失败的患者。在过去的二十年中，CD 的手术治疗取得了相当大的进展。一些手术干预措施，如切除长段肠管或导致确定性造口术，应避免使用，仅在治疗失败时才进行。另一方面，对于某些适应症，适当的微创手术可以替代长期药物治疗。进行早期手术的决定应考虑术后应用的策略。多学科团队的决策至关重要。
