Center for Interventional Inflammatory Bowel Disease, Columbia University Irving Medical Center, New York Presbyterian Hospital, NY, USA.
Division of Gastroenterology, Hepatology, and Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.
Lancet Gastroenterol Hepatol. 2021 Jun;6(6):482-497. doi: 10.1016/S2468-1253(20)30394-0. Epub 2021 Apr 17.
The majority of patients with Crohn's disease and a proportion of patients with ulcerative colitis will ultimately require surgical treatment despite advances in diagnosis, therapy, and endoscopic interventions. The surgical procedures that are most commonly done include bowel resection with anastomosis, strictureplasty, faecal diversion, and ileal pouch. These surgical treatment modalities result in substantial alterations in bowel anatomy. In patients with inflammatory bowel disease, endoscopy plays a key role in the assessment of disease activity, disease recurrence, treatment response, dysplasia surveillance, and delivery of endoscopic therapy. Endoscopic evaluation and management of surgically altered bowel can be challenging. This consensus guideline delineates anatomical landmarks and endoscopic assessment of these landmarks in diseased and surgically altered bowel.
尽管在诊断、治疗和内镜介入方面取得了进展,但大多数克罗恩病患者和一部分溃疡性结肠炎患者最终仍需要手术治疗。最常进行的手术包括肠切除吻合术、狭窄成形术、粪便转流术和回肠袋。这些手术治疗方式会导致肠道解剖结构的重大改变。在炎症性肠病患者中,内镜在评估疾病活动度、疾病复发、治疗反应、异型增生监测和内镜治疗方面发挥着关键作用。内镜评估和治疗手术改变后的肠道可能具有挑战性。本共识指南阐述了病变和手术改变后的肠道的解剖标志和内镜评估。