Eigler F W, Lange R, Luetkens S
Abteilung für Allgemeine Chirurgie, Universitätsklinikum Essen.
Langenbecks Arch Chir. 1988;Suppl 2:83-7.
A conservative attitude to surgical treatment of Crohn's disease may endanger patients, lives, especially in acute situations. Indications for emergency operation and intraoperative management are subject to special rules. Resection should be minimal but terminated in a marcospically disease-free area. In case of performation, resection is mandatory; mere sewing closed is inadequate. Subtotal colectomy should be performed in cases of toxic megacolon. Abscesses should be drained using a pig-tail catheter; if the abscesses do not heal, surgery is necessary.
对克罗恩病采取保守的手术治疗态度可能会危及患者生命,尤其是在急性情况下。急诊手术的指征和术中管理遵循特殊规则。切除范围应尽量小,但要在肉眼可见无病变的区域结束。如果发生穿孔,必须进行切除;单纯缝合是不够的。在出现中毒性巨结肠的情况下应进行次全结肠切除术。脓肿应使用猪尾导管引流;如果脓肿不愈合,则需要进行手术。