Lei Miao-Lin, Dong Li-Li, Yu Yan-Bo
Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China.
Department of Gastroenterology, Affiliated Qingdao Third People's Hospital, Qingdao University, Qingdao 266001, Shandong Province, China.
World J Gastrointest Surg. 2025 Jul 27;17(7):100766. doi: 10.4240/wjgs.v17.i7.100766.
Studies have indicated that approximately half of individuals with Crohn's disease (CD) may undergo surgery at some point during their lifetime. Ileocolic resection (ICR) is the most frequently performed procedure for treating CD. Addressing anastomotic leak (AL) remains a critical focus in the perioperative and postoperative care of CD patients. A research study published in the by Cwaliński included 77 individuals who had open ICR and primary stapled anastomosis to assess the risk factors linked to anastomotic insufficiency. At present, research on anastomotic insufficiency has focused on AL. Therefore, this editorial mainly analyzes the current risk factors linked to AL after ICR and discusses potential prevention strategies. We comprehensively consider risk factors such as body weight, medication use, surgical history, smoking, penetrating behaviour, and albumin levels to stratify patient risk. Based on recent research insights, we propose that individualized surgical timing, approaches, and techniques should be selected according to the patient's risk level.
研究表明，大约一半的克罗恩病（CD）患者在其一生中的某个阶段可能会接受手术。回结肠切除术（ICR）是治疗CD最常施行的手术。解决吻合口漏（AL）仍然是CD患者围手术期和术后护理的关键重点。Cwaliński发表在[期刊名称未给出]上的一项研究纳入了77例行开放性ICR和一期吻合器吻合术的患者，以评估与吻合口功能不全相关的危险因素。目前，关于吻合口功能不全的研究主要集中在AL上。因此，本社论主要分析目前与ICR术后AL相关的危险因素，并讨论潜在的预防策略。我们综合考虑体重、用药情况、手术史、吸烟、穿透性病变行为和白蛋白水平等危险因素来对患者风险进行分层。基于最近的研究见解，我们建议应根据患者的风险水平选择个体化的手术时机、手术方式和技术。
