炎症性肠病中的结肠狭窄:流行病学、并发症和管理。

Colonic Strictures in Inflammatory Bowel Disease: Epidemiology, Complications, and Management.

机构信息

Department of Gastroenterology, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France.

Pathology Unit, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France.

出版信息

J Crohns Colitis. 2021 Oct 7;15(10):1766-1773. doi: 10.1093/ecco-jcc/jjab068.

Abstract

The management of colorectal stricture complicating inflammatory bowel disease [IBD] remains a challenging condition. Stricture raises concern about neoplastic complications, which cannot be fully ruled out by negative endoscopic biopsies. Also, impassable strictures restrict the endoscopic monitoring of upstream disease activity and dysplasia. Surgery remains the 'gold standard' treatment for colonic strictures but is associated with high morbidity. Over the past few decades, our therapeutic arsenal for IBD has been reinforced by biologics and therapeutic endoscopy. Few studies have focused on colonic strictures, and so current therapeutic strategies are based on a low level of evidence and applied by analogy with the treatment of ileal strictures. With a view to facilitating the decision making process in clinical practice, we reviewed the literature on the epidemiology, natural history, and management of colonic strictures in IBD.

摘要

结直肠狭窄是炎症性肠病(IBD)的并发症,其管理仍然是一个具有挑战性的问题。狭窄会引起对肿瘤性并发症的担忧,而阴性的内镜活检并不能完全排除这些并发症。此外,无法通过的狭窄限制了对上游疾病活动和异型增生的内镜监测。手术仍然是结直肠狭窄的“金标准”治疗方法,但它与高发病率有关。在过去的几十年中,我们治疗 IBD 的武器库已经通过生物制剂和治疗性内镜得到了加强。很少有研究关注结直肠狭窄,因此目前的治疗策略是基于低水平的证据,并通过类比治疗回肠狭窄来应用。为了便于在临床实践中做出决策,我们回顾了关于 IBD 中结直肠狭窄的流行病学、自然史和管理的文献。

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