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克罗恩病患者回结肠吻合口功能不全——预防与治疗

Insufficiency of ileocolic anastomosis in Crohn's disease patients - prevention and treatment.

作者信息

Cwaliński Jarosław, Stawczyk-Eder Kamila, Cwalinska Agnieszka, Zasada Wiktoria, Cholerzyńska Hanna, Banasiewicz Tomasz, Paszkowski Jacek

机构信息

Department of General, Endocrinological Surgery and Gastrointestinal Oncology, Poznan University of Medical Sciences, Poznan 60-355, Poland.

Department of Gastroenterology, Dietetics, and Internal Medicine, Poznan University of Medical Sciences, Poznan 60-355, Poland.

出版信息

World J Gastrointest Surg. 2025 May 27;17(5):102064. doi: 10.4240/wjgs.v17.i5.102064.

Abstract

Resection of the terminal ileum and ileocecal valve remains the most commonly performed procedure in patients with Crohn's disease. However, despite radical treatment, there is a risk of disease recurrence at the site of the intestinal anastomosis in some cases. Therefore, long-term postoperative management is crucial and requires systematic clinical assessment, endoscopic surveillance, and pharmacological support when indicated. A key challenge is identifying the risk factors associated with the recurrence of anastomotic failure and defining the principles of follow-up care to prevent secondary intestinal insufficiency. This paper focuses on both surgical and non-surgical factors that may play a role in preventing complications in patients undergoing ileocecal resection, providing a comprehensive approach to postoperative management.

摘要

切除回肠末端和回盲瓣仍然是克罗恩病患者最常施行的手术。然而,尽管进行了根治性治疗,但在某些情况下,肠吻合部位仍有疾病复发的风险。因此,术后长期管理至关重要,需要进行系统的临床评估、内镜监测,并在必要时给予药物支持。一个关键挑战是识别与吻合口失败复发相关的风险因素,并确定预防继发性肠功能不全的随访原则。本文重点关注可能在预防回盲部切除患者并发症方面发挥作用的手术和非手术因素,提供一种全面的术后管理方法。

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