Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY 40292, USA.
Colorectal Surgery, Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY 40292, USA.
Adv Surg. 2024 Sep;58(1):19-34. doi: 10.1016/j.yasu.2024.04.002. Epub 2024 May 16.
Complications of Crohn's disease reach far beyond postsurgical leak, infection, and enterocutaneous fistula. Malnutrition, intestinal failure, and recurrent disease all will require ongoing attentions. The management of these patients may further be complicated by the need for chronic immunosuppression. The underlying principles continue to include optimization of nutritional status, and preservation of bowel length when possible. However, there have been several recent advances in both the medical and surgical management of the disease. Understanding the contribution of the mesentery to inflammation, new surgical techniques such as the Kono-S anastomosis and extended mesenteric resection is decreasing the need for repeated resections.
克罗恩病的并发症远不止术后漏、感染和肠皮瘘。营养不良、肠衰竭和疾病复发都需要持续关注。这些患者的管理可能因需要慢性免疫抑制而进一步复杂化。这些患者的管理可能因需要慢性免疫抑制而进一步复杂化。管理这些患者的基本原则仍然包括优化营养状况,并尽可能保留肠段。然而,在疾病的内科和外科治疗方面,已经有了一些近期的进展。对肠系膜在炎症中的作用的认识,以及科诺- S 吻合术和扩大肠系膜切除术等新的手术技术,减少了重复切除的需要。