State-of-the-art surgery for Crohn’s disease: Part I—small intestine/ileal disease

Kavalukas, Sandra L.; Scheurlen, Katharina M.; Galandiuk, Susan

doi:10.1007/s00423-021-02324-4

Cited by 6 publications

(7 citation statements)

References 49 publications

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“…This technique preserves bowel length and can prevent short bowel complications in patients with a history of prior bowel resection. For strictures shorter than 10 cm in length, the Heineke-Mikulicz method is a common strictureplasty technique, while the Finney strictureplasty is suggested for longer strictures up to 25 cm in length [108]. Postoperative complication rates of strictureplasty are similar to those of bowel resection.…”

Section: • Surgical Therapymentioning

confidence: 99%

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Unmet Challenges in Patients with Crohn’s Disease

Scheurlen,

Parks,

Macleod

et al. 2023

JCM

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Patients with Crohn’s disease can present with a variety of clinical manifestations; treatment strategies should focus on long-term remission and improvement of quality of life. There is no standardized process of diagnosing, predicting prognosis, and treating the disease. This narrative review was based on a literature search using PubMed, Embase, and Science Direct. Data on unmet challenges in patients with Crohn’s disease were extracted from identified manuscripts. The aim was to discuss present research on standardized processes in the management of patients with Crohn’s disease and to identify the unmet needs in clinical evaluation and treatment approaches. There is no consensus on standardized diagnostic, treatment, and surveillance algorithms, particularly in assessing complications of Crohn’s, such as stricturing disease, intestinal cancer risk, and cutaneous manifestations. Complications and treatment failure rates of conventional, interventional, and surgical therapy place emphasis on the need for standardized treatment algorithms, particularly in the case of acute complications of the disease. Research on standardized clinical approaches, reliable biomarkers for disease diagnosis and therapy monitoring, and new treatment agents is necessary to improve therapy and reduce complications in patients with Crohn’s disease.

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Section: • Surgical Therapymentioning

confidence: 99%

“…Strictureplasty may be indicated in cases of multiple shorter fibrotic strictures in the absence of infection, such as phlegmon, abscess, fistula, or perforation [108]. This technique preserves bowel length and can prevent short bowel complications in patients with a history of prior bowel resection.…”

Section: • Surgical Therapymentioning

confidence: 99%

Unmet Challenges in Patients with Crohn’s Disease

Scheurlen,

Parks,

Macleod

et al. 2023

JCM

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“…Recent advances in surgical approaches and different anastomotic techniques have highlighted the importance of considering various operative factors and led to the development of different surgical options, each with a different risk of POR [ 28 , 29 , 30 ]. Evidence indicates stapled intestinal anastomoses, whether side-to-side or end-to-end, demonstrate superior outcomes relative to hand-sewn techniques (anastomotic leak rate of 2% vs. 14%) [ 31 , 32 ]. Additionally, a systematic review and meta-analysis compared endoscopic POR rates in CD patients based on the ileocolonic anastomosis technique, specifically the conventional types (side-to-side, end-to-end, or end-to-side) or Kono-S anastomosis [ 33 ].…”

Section: Monitoringmentioning

confidence: 99%

The Management of Postoperative Recurrence in Crohn’s Disease

Fasulo,

D’Amico,

Osorio

et al. 2023

JCM

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Crohn’s disease (CD) is a chronic inflammatory bowel disease with different phenotypes of presentation, inflammatory, penetrating, or stricturing disease, that significantly impacts patient well-being and quality of life. Despite advances in medical therapy, surgery sometimes represents the only treatment to address complications, such as strictures, fistulas, or abscesses. Minimizing postoperative recurrence (POR) remains a major challenge for both clinicians and patients; consequently, various therapeutic strategies have been developed to prevent or delay POR. The current review outlines an updated overview of POR management. We focused on diagnostic assessment, which included endoscopic examination, biochemical analyses, and cross-sectional imaging techniques, all crucial tools used to accurately diagnose this condition. Additionally, we delved into the associated risk factors contributing to POR development. Furthermore, we examined recent advances in the prophylaxis and treatment of POR in CD.

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“…CD patients refractory to medical or endoscopic treatment, or with complex complications (strictures, abscesses, and fistulae), would eventually need surgical interventions such as strictureplasty (SXP) and bowel resection. 1 , 92 Bislenghi et al 93 conducted a meta-analysis including 26 studies aiming to explore the efficacy of conventional (short and intermediate procedures such as Heineke–Mikulicz and Finney) and nonconventional (long entero-enterostomies such as Michelassi) SXP. Results showed a comparatively low rate of postoperative complications (15.5% versus 19.2%) and surgical recurrence (26.9% versus 18.2%) for the two types of surgical therapies during median follow-up periods of 65.3 and 96.3 months, respectively, suggesting that both techniques were feasible.…”

Section: Search Strategymentioning

confidence: 99%

Intestinal strictures in Crohn’s disease: a 2021 update

Lin

Wang

Liu

et al. 2022

Therap Adv Gastroenterol

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Intestinal strictures remain one of the most intractable and common complications of Crohn’s disease (CD). Approximately 70% of CD patients will develop fibrotic strictures after 10 years of CD diagnosis. Since specific antifibrotic therapies are unavailable, endoscopic balloon dilation and surgery remain the mainstay treatments despite a high recurrence rate. Besides, there are no reliable methods for accurately evaluating intestinal fibrosis. This is largely due to the fact that the mechanisms of initiation and propagation of intestinal fibrosis are poorly understood. There is growing evidence implying that the pathogenesis of stricturing CD involves the intricate interplay of factors including aberrant immune and nonimmune responses, host-microbiome dysbiosis, and genetic susceptibility. Currently, the progress on intestinal strictures has been fueled by the advent of novel techniques, such as single-cell sequencing, multi-omics, and artificial intelligence. Here, we perform a timely and comprehensive review of the substantial advances in intestinal strictures in 2021, aiming to provide prompt information regarding fibrosis and set the stage for the improvement of diagnosis, treatment, and prognosis of intestinal strictures.

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State-of-the-art surgery for Crohn’s disease: Part I—small intestine/ileal disease

Cited by 6 publications

References 49 publications

Unmet Challenges in Patients with Crohn’s Disease

Unmet Challenges in Patients with Crohn’s Disease

The Management of Postoperative Recurrence in Crohn’s Disease

Intestinal strictures in Crohn’s disease: a 2021 update

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