Shah Ravi S, Click Benjamin H
Cleveland Clinic - Internal Medicine, 9500 Euclid Ave, Cleveland, OH 44195, USA.
Cleveland Clinic - Gastroenterology, Hepatology, and Nutrition, Cleveland, OH, USA.
Therap Adv Gastroenterol. 2021 Feb 15;14:1756284821993581. doi: 10.1177/1756284821993581. eCollection 2021.
Postoperative recurrence of Crohn's disease is common and requires a multidisciplinary approach between surgeons and gastroenterologists in the perioperative and postoperative period to improve outcomes in this patient population. Endoscopic recurrence precedes clinical and surgical recurrence and endoscopic monitoring is crucial to guide postoperative management. Risk stratification of patients is recommended to guide early prophylactic management, and follow-up endoscopic monitoring can guide intensification of therapy. This review summarizes evidence behind postoperative recurrence rates, disease monitoring techniques, nonbiologic and biologic therapies available to prevent and treat postoperative recurrence, risk factors associated with recurrence, and postoperative management strategies guided by endoscopic monitoring.
克罗恩病术后复发很常见，在围手术期和术后阶段，外科医生和胃肠病学家之间需要采取多学科方法，以改善该患者群体的治疗效果。内镜复发先于临床和手术复发，内镜监测对于指导术后管理至关重要。建议对患者进行风险分层以指导早期预防性管理，而随访内镜监测可指导强化治疗。本综述总结了术后复发率、疾病监测技术、可用于预防和治疗术后复发的非生物和生物疗法、与复发相关的危险因素以及由内镜监测指导的术后管理策略背后的证据。
