克罗恩病手术后的管理。

Management of Crohn's Disease After Surgical Resection.

机构信息

Division of Gastroenterology, University of California San Diego, 9452 Medical Center Drive, ACTRI 1W501, La Jolla, CA 92093, USA; Division of Biomedical Informatics, University of California San Diego, 9452 Medical Center Drive, ACTRI 1W501, La Jolla, CA 92093, USA.

Joseph and Wolf Lebovic Health Complex, Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Mount Sinai Hospital, University of Toronto, Suite 437, 600 University Avenue, Toronto, Ontario M5G 1x5, Canada; Institute for Clinical Evaluative Sciences, 155 College Street, Suite 424, Toronto, Ontario M5T 3M6, Canada.

出版信息

Gastroenterol Clin North Am. 2017 Sep;46(3):563-575. doi: 10.1016/j.gtc.2017.05.011.

DOI:10.1016/j.gtc.2017.05.011

PMID:28838415

Abstract

Approximately 25% to 35% of patients with Crohn's disease (CD) who undergo surgery require repeat surgery. Active smoking, multiple prior surgeries, and penetrating or perianal disease are risk factors for recurrence of CD after surgical resection. Early initiation of prophylactic therapy is effective in decreasing the risk of recurrence. Active colonoscopic surveillance for the early detection of endoscopic recurrence within 6 to 12 months of surgery is recommended. In symptomatic patients without evidence of endoscopic recurrence, noninflammatory causes should be sought.

摘要

约 25%至 35%的克罗恩病 (CD) 患者需要接受手术，其中约 25%至 35%的患者需要再次手术。吸烟、多次手术史以及穿透性或肛周疾病是 CD 术后复发的危险因素。手术切除后尽早开始预防治疗可有效降低复发风险。建议在术后 6 至 12 个月内行结肠镜监测以早期发现内镜复发。对于无症状但无内镜复发证据的患者，应寻找非炎症性病因。