手术与小儿炎症性肠病
Surgery and paediatric inflammatory bowel disease.
作者信息
Kelay Arun, Tullie Lucinda, Stanton Michael
机构信息
Department of Paediatric Surgery, University Hospital Southampton, Southampton, UK.
出版信息
Transl Pediatr. 2019 Dec;8(5):436-448. doi: 10.21037/tp.2019.09.01.
Abstract
The incidence of paediatric Crohn's disease (CD) and ulcerative colitis (UC) is increasing. Surgical intervention is required during childhood in approximately 25% of children diagnosed with CD, and for 10% of those diagnosed with UC. Although there is evidence that the rate of surgical intervention undertaken in children is decreasing since the introduction of biologic therapy, this may only represent a delay rather than true reversal of the risk of surgery. Surgery for CD is not curative and limited resection is the key principle thus preserving bowel length. For UC, subtotal colectomy is relatively curative; ileo-anal pouch anastomosis can be performed to restore bowel continuity.
摘要
儿童克罗恩病（CD）和溃疡性结肠炎（UC）的发病率正在上升。在确诊为CD的儿童中，约25%在儿童期需要手术干预，而确诊为UC的儿童中这一比例为10%。尽管有证据表明，自生物治疗引入以来，儿童接受手术干预的比例在下降，但这可能只是延迟了手术风险，而非真正降低了风险。CD手术无法治愈，有限切除是关键原则，从而保留肠管长度。对于UC，次全结肠切除术相对可治愈；可进行回肠肛管吻合术以恢复肠道连续性。
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