| Theme |
Surgical therapy for Crohn's disease -- Essentials for physician |
| Title |
Prevention of surgical recurrence in Crohn's disease |
| Author |
Toru Kono |
Division of Gastroenterologic and General Surgery, Department of Surgery, Asahikawa Medical University |
| [ Summary ] |
The number of surgical therapies performed for Crohn's disease-induced intestinal lesions is extremely high, raising concerns of a vicious cycle of surgical recurrence due to relapse or recurrence of the disease. The causative role of smoking as a lifestyle factor in Crohn's disease should be excluded. Strictureplasty is advocated as the surgical technique of chice for treating minute lesions of the small bowel. Nevertheless, the 10-year reoperation rate remains at 25 %. Bowel resection is performed in many cases of small and large bowel lesions, with exceptionally high rates of repeated surgery for anastomic restenosis sfter resection of diseased bowels (25 % in 5 years). Currently, hand-sewn side-to-side anastomosis is favored over functional end-to-end anastomosis for the prevention of recurrence and adhesions. A new anastomosis technique (S anastomosis technique) whitch takes into account the characteristics of recurrence and Crohn's disease is anticipated. |