Turri Giulia, Carvello Michele, Ben David Nadav, Spinelli Antonino
Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy.
Department of Surgical Sciences, Dentistry, Gynecology, and Pediatrics, Division of General and Hepatobiliary Surgery, University of Verona, Verona, Italy.
Clin Colon Rectal Surg. 2022 Apr 13;35(4):321-327. doi: 10.1055/s-0042-1743590. eCollection 2022 Jul.
Crohn's disease (CD) is a chronic relapsing inflammatory bowel disease with unknown etiology. Up to 80% of patients will eventually require surgery throughout their lifetime, and often repeated resections are required for disease recurrence. Observations of "creeping fat" surrounding the diseased intestine renewed interest in the mesentery, recently defined as an organ with endocrine and immune functions. According to the inside-out model, the mesentery may be primarily affected in CD and subsequent cause alterations in the mucosa. Recently, lower surgical recurrence rates have been reported with en-bloc excision of the mesentery adjoining the diseased intestine. Results of ongoing randomized controlled trials may clarify the role of the mesentery in CD and possibly lead to its adoption as standard during surgery for Crohn's disease.
克罗恩病（CD）是一种病因不明的慢性复发性炎症性肠病。高达80%的患者最终在其一生中需要接受手术，并且疾病复发时常常需要反复进行切除手术。对病变肠管周围“爬行脂肪”的观察重新引发了人们对肠系膜的兴趣，肠系膜最近被定义为一个具有内分泌和免疫功能的器官。根据由内而外的模型，肠系膜可能在克罗恩病中首先受到影响，随后导致黏膜发生改变。最近有报道称，对病变肠管毗邻的肠系膜进行整块切除后手术复发率较低。正在进行的随机对照试验的结果可能会阐明肠系膜在克罗恩病中的作用，并可能使其在克罗恩病手术中成为标准术式。
