Ogino Takayuki, Mizushima Tsunekazu, Matsuda Chu, Mori Masaki, Doki Yuichiro
Department of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka Japan.
Department of Therapeutics for Inflammatory Bowel Diseases Graduate School of Medicine Osaka University Osaka Japan.
Ann Gastroenterol Surg. 2019 Dec 16;4(1):30-38. doi: 10.1002/ags3.12304. eCollection 2020 Jan.
This review outlines current topics on the surgical treatment of benign colorectal diseases, with a focus on inflammatory bowel disease (IBD) and diverticulitis. Treatment options for IBD and diverticulitis have evolved in the last few years as a result of medical advances in technology and new clinical trials. Therefore, treatment options and strategies need to be updated to provide optimal care for patients. The purpose of this review is to elucidate recent global trends and update the surgical treatment strategy for IBD and diverticulitis based on literature published in the past 2 years. Prevalence of IBD, including ulcerative colitis and Crohn's disease, has increased over the last few decades. During this period, many new medical therapies were introduced for the treatment of IBD, including biological therapy, immunomodulators, and leukocyte apheresis therapy. As a result, new surgical strategies for IBD are required. In order to improve surgical outcomes in IBD patients, the influence of preoperative treatment on postoperative complications needs to be considered. The incidence of diverticulitis is also increasing with lifestyle changes and increasing numbers of older people. For diverticulitis with perforation and generalized peritonitis, surgery is the gold standard. Elective surgery after conservative treatment of diverticulitis is also an option because of high recurrence rates. With an increase in diverticulitis, systematic strategies are essential for an appropriate approach to diverticulitis, taking into account various factors, including the patient's background.
本综述概述了良性结直肠疾病外科治疗的当前主题,重点关注炎症性肠病(IBD)和憩室炎。由于技术的医学进步和新的临床试验,IBD和憩室炎的治疗选择在过去几年中不断发展。因此,需要更新治疗选择和策略,为患者提供最佳护理。本综述的目的是根据过去两年发表的文献阐明近期全球趋势,并更新IBD和憩室炎的外科治疗策略。在过去几十年中,包括溃疡性结肠炎和克罗恩病在内的IBD患病率有所上升。在此期间,引入了许多用于治疗IBD的新医学疗法,包括生物疗法、免疫调节剂和白细胞去除术疗法。因此,需要新的IBD外科治疗策略。为了改善IBD患者的手术结局,需要考虑术前治疗对术后并发症的影响。随着生活方式的改变和老年人数量的增加,憩室炎的发病率也在上升。对于伴有穿孔和弥漫性腹膜炎的憩室炎,手术是金标准。由于复发率高,憩室炎保守治疗后择期手术也是一种选择。随着憩室炎发病率的增加,考虑到包括患者背景在内的各种因素,系统的策略对于正确处理憩室炎至关重要。