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18-02-2023 | Crohn's Disease | Editorial and Commentary

Surgical priorities in abdominal Crohn’s disease

Authors: Zachary J. Roberts, Alessandro Fichera

Published in: Updates in Surgery | Issue 3/2023

Abstract

Crohn’s disease is a chronic disorder associated with a high rate of recurrence and morbidity. New therapies have been developed over the last few decades that have improved both induction of remission and lowered recurrence rates which led to improved outcomes. An overarching set of principles connects these therapies with prevention of recurrence being the top priority. To achieve the best outcomes, patients must be carefully chosen, optimized, and the correct surgery performed by an experienced and multidisciplinary team at the appropriate time. We seek to outline the current evidence-based approach to the surgical management of Crohn’s disease.

Guo Z, Cao L, Guo F et al (2017) The presence of postoperative infectious complications is associated with the risk of early postoperative clinical recurrence in Crohn’s disease. World J Surgery 41:2371–2377. https://doi.org/10.1007/s00268-017-4026-3CrossRef

Reese GE, Nanidis T, Borysiewicz C et al (2008) The effect of smoking after surgery for Crohn’s disease: a meta analysis of observational studies. Int J Colorectal Dis 23:1213–1221. https://doi.org/10.1007/s00384-008-0542-9CrossRefPubMed

Van Gossum A, Cabre E, Hébuterne X et al (2009) ESPEN guidelines on parenteral nutrition: gastroenterology. Clin Nutr 28:415–427. https://doi.org/10.1016/j.clnu.2009.04.022CrossRefPubMed

Ponsioen CY, de Groof EJ, Eshuis EJ et al (2017) Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn’s disease: a randomized controlled, open-label, multicentre trial. Lancet Gastroenterol Hepatol 2:785–792. https://doi.org/10.1016/S2468-1253(17)30248-0CrossRefPubMed

Cohen BL, Fleshner PR, Kane SV et al (2019) Anti-tumor necrosis factor is not associated with postoperative infections: results from prospective cohort of ulcerative colitis and Crohn’s disease patients undergoing surgery to identify risk factors for postoperative infections (PUCCINI). Gastroenterology 156:80. https://doi.org/10.1016/S0016-5085(19)36987-2CrossRef

Fichera A, Lovadina S, Rubin M et al (2006) Patterns and operative treatment of recurrent Crohn’s disease: a prospective longitudinal study. Surgery 140:649–654. https://doi.org/10.1016/j.surg.2006.07.011CrossRefPubMed

Ng CH, Chin YH, Lin SY et al (2021) Kono-S anastomosis for Crohn’s disease: a systemic review, meta-analysis, and meta-regression. Surg Today 51:493–501. https://doi.org/10.1007/s00595-020-02130-3CrossRefPubMed

Kono T, Fichera A, Maeda K et al (2016) Kono-S anastomosis for surgical prophylaxis of anastomotic recurrence in crohn’s disease: an international multicenter study. J Gastrointest Surg 20(4):783–790. https://doi.org/10.1007/s11605-015-3061-3CrossRefPubMed

Luglio G, Rispo A, Imperatore N et al (2020) Surgical prevention of anastomotic recurrence by excluding mesentery in Crohnʼs disease: the SuPREMe-CD study: a randomized clinical trial. Ann Surg 272:210–217. https://doi.org/10.1097/SLA.0000000000003821CrossRefPubMed

10.

Bislenghi G, Sucameli F, Fieuws S et al (2022) Non-conventional versus conventional strictureplasties for crohn’s disease a systematic review and meta-analysis of treatment outcomes. J Crohns Colitis 16(2):319–330. https://doi.org/10.1093/ecco-jcc/jjab146CrossRefPubMed

11.

Patel SV, Patel SV, Ramagopalan SV et al (2013) Laparoscopic surgery for Crohn’s disease: a meta-analysis of perioperative complications and long term outcomes compared with open surgery. BMC Surg 24(13):14. https://doi.org/10.1186/1471-2482-13-14CrossRef

Title: Surgical priorities in abdominal Crohn’s disease
Authors: Zachary J. Roberts
Alessandro Fichera
Publication date: 18-02-2023
Publisher: Springer International Publishing
Keyword: Crohn's Disease
Published in: Updates in Surgery / Issue 3/2023
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-023-01456-0

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Surgical priorities in abdominal Crohn’s disease

Abstract

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Abstract

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