| Theme |
How Do You Choose Treatment Strategies for IBD Patients with a Critical Situation? |
| Title |
Indication for Surgery and Postoperative Management in Crohn's Disease |
| Author |
Hideaki Kimura |
Inflammatory Bowel Disease Center, Yokohama City University Medical Center |
| Author |
Reiko Kunisaki |
Inflammatory Bowel Disease Center, Yokohama City University Medical Center |
| Author |
Kenji Tatsumi |
Inflammatory Bowel Disease Center, Yokohama Municipal Citizen's Hospital |
| Author |
Kazutaka Koganei |
Inflammatory Bowel Disease Center, Yokohama Municipal Citizen's Hospital |
| Author |
Akira Sugita |
Inflammatory Bowel Disease Center, Yokohama Municipal Citizen's Hospital |
| Author |
Itaru Endo |
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine |
| [ Summary ] |
Good patient quality of life is the main purpose of surgical treatment in Crohn's disease. When the disease does not respond to medical therapies, surgery is required. The common indications for surgery are bowel obstruction secondary to stricture and fistula. Perforation, massive bleeding, intractable disease, and cancer also require surgery. Resection and strictureplasty are mainly performed while sparing the normal tissue as much as possible. It is important to consider how much intestinal tract should be removed. For the prevention of postoperative recurrence, surgical strategy, the type of anastomosis, postoperative maintenance therapy, and colonoscopy should be consid-ered. The postoperative management strategy should be planned after stratifying patients according to their individual risk of recurrence. |