Suppression of macrophage function by suture materials and anastomotic recurrence of Crohn's disease

Scott, A. D. N.; Uff, C. R.; Rw, Phillips

doi:10.1002/bjs.1800800342

Cited by 15 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Concern has been raised that anastomotic stapling techniques result in a localized ischemic injury that might increase CD recurrence 23,54. Conversely, suture materials have been found to alter macrophage function, and this has been proposed as a reason why hand‐sewn anastomoses might be at higher risk 55. Clinical studies have had variable results.…”

Section: Surgical Techniquementioning

confidence: 99%

Postoperative Crohnʼs Disease

Penner

Madsen

Fedorak

2005

Inflammatory Bowel Diseases

View full text Add to dashboard Cite

More than three quarters of patients with Crohn's disease (CD) will require surgery. After resection, disease recurs postoperatively with a median time to second resection of about 10 years. Despite its importance, the postoperative period remains one of the most poorly understood clinical settings in the field. Postoperatively, CD may exhibit unique pathophysiologic features, but the current state of knowledge does not allow for identification of patients at risk for relapse, and leaves clinicians without guidance on optimal maintenance treatment. Therapies used as maintenance for CD in other settings may have different efficacies when used after surgery, and clinical research in patients requiring surgery is limited by the subset of patients available for study. Despite the many limitations in current knowledge of postoperative CD, it is an exciting field because new developments have improved patient care, and ongoing research has the potential for further gains.

show abstract

Section: Surgical Techniquementioning

confidence: 99%

Postoperative Crohnʼs Disease

Penner

Madsen

Fedorak

2005

Inflammatory Bowel Diseases

View full text Add to dashboard Cite

show abstract

“…In five patients with CD, intestinal anastomoses were constructed with linear staplers, creating wide side-to-side anastomoses. The choice of this type of anastomosis was based on our own encouraging experience in adult patients and convincing positive data on this technique from the literature (8,9,10).…”

Section: Resultsmentioning

confidence: 99%

Surgery for Inflammatory Bowel Disease in Children and Adolescents

Meissner¹,

Szabłoński²,

Krokowicz³

et al. 2007

Polish Journal of Surgery

View full text Add to dashboard Cite

in Poznań 3 Kierownik: prof. dr hab. W. Cichy Recent decades have seen a constant rise in the incidence of IBD in both adults and children. Despite considerable progress in the pharmacological treatment of this disease, surgery has become the more frequently used treatment modality in younger patients. In the presence of massive haemorrhage, free perforation, fulminate colitis or acute obstruction, only surgical intervention has a chance of saving the patient's life. The aim of the study was to present the results of surgical treatment of IBD in children and adolescents who were operated on in a department which copes with "adult surgery" in its everyday practice. Materials and methods. 235 patients were operated on for IBD in the years 1998-2005. There were 18 (7,66%) children in this group, 10 girls and 8 boys. 12 patients were diagnosed with ulcerative colitis (66.7 %) and (6) patients were diagnosed with Crohn's disease (33.3%). The age of the patients ranged from 12 to 17 years (mean 15.6). Among the 18 children, 10 (55.6%) were operated on for elective reasons and 8 (44.4%) of the interventions were emergencies (three perforations, two obstructions, one acute haemorrhage and one fulminate colitis). In all cases of ulcerative colitis, a two-step restorative proctocolectomy with J pouch anal anastomosis was performed. Patients with Crohn's disease were treated by limited (sparing)[it seems that either limited or sparing works here, pick one] bowel resection and/or strictureplasty. Results. There were no postoperative deaths in the study group. Postoperative complications were observed in 6 (33.3%) patients, the complications were ileus in 3 patients (1 patient demanded relaparotomy), pneumonia in 2 patients and wound suppuration with subsequent dehiscence in 1 patient. In one patient treated preoperatively with large doses of Imuran, the postoperative histology revealed a malignant lymphoma. Hospital stays ranged from 8 to 19 days (mean 12 days). Conclusions. Surgery for IBD in children and adolescents has become a widely accepted method, and it is often the only treatment modality that offers a chance of a cure. Restorative proctocolectomy should be considered earlier in many cases of younger patients with ulcerative colitis, prior to conservative treatment, as imunosupression and steroid therapy in particular produce undesired side effects. A consulting surgeon should be involved in the treatment of younger patients with IBD at a much earlier stage of therapy than is currently practiced.

show abstract

“…Therefore, surgical injury to the patient could be minimized and the bowel function could recover earlier. Moreover, previous studies demonstrated that persistent foreign bodies may be responsible for anastomotic recurrence of cancer and inflammatory bowel disease and affect radiological examination [17,18] . Although no recurrence at anastomotic site was found in our study during the 6-mo follow-up period, further study is needed.…”

Section: Discussionmentioning

confidence: 99%