| Theme |
Current Therapy of IBD |
| Title |
Surgical Treatment for Crohnʼs Disease |
| Author |
Kazutaka Koganei |
Department of Surgery, Yokohama Municipal Hospital |
| Author |
Kenji Tatsumi |
Department of Surgery, Yokohama Municipal Hospital |
| Author |
Katsuhiko Arai |
Department of Surgery, Yokohama Municipal Hospital |
| Author |
Hideaki Kimura |
Inflammatory Bowel Disease Center, Yokohama City University Medical Center |
| Author |
Ryo Futatsuki |
Department of Surgery, Yokohama Municipal Hospital |
| Author |
Hirosuke Kuroki |
Department of Surgery, Yokohama Municipal Hospital |
| Author |
Akira Sugita |
Department of Surgery, Yokohama Municipal Hospital |
| [ Summary ] |
Surgery for Crohnʼs disease should be performed for severe disease and complications that are resistant to medical therapy. The aim is restore patients to acceptable levels of daily activity. Indications for surgery are as follows；intestinal obstructions, perforations, massive hemorrhage, cancer, abscesses, internal or external fistulas, anorectal complications and growth retardation. Relapse is common in Crohnʼs disease and repeated operations may be necessary, preservation of bowel length should be considered. Minimal segmental resection of diseased bowels and strictureplasty are the principle of this surgery. Anorectal complications are first treated with local surgery, such as seton drainage. However, defunctioning stoma or abdominoperineal resection may be needed for some patients with anorectal lesions resistant to both medical therapy and local surgery. Collaboration between gastroenterologists and surgeons is important to decide on the optimal timing of surgery. To improve the outcome of surgery, establishment of prophylaxis for postoperative recurrence is needed. |