The Role of Active Inflammation and Surgical Therapy in Crohn’s Disease Recurrence

Ingallinella, Sara; Campanelli, Michela; Antonelli, Antonello; Arcudi, Claudio; Bellato, Vittoria; Divizia, Andrea; Franceschilli, Marzia; Petagna, Lorenzo; Sensi, Bruno; Sibio, Simone; Siragusa, Leandro; Sica, Giuseppe

doi:10.1155/2020/2845407

Cited by 5 publications

(5 citation statements)

References 73 publications

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“…15 29 According to that, the inflammatory trigger in the mesentery stimulates adipocytes and fibroblasts to secrete adipokines and cytokines that in turn perpetuate intestinal inflammation and fibrosis. 15 30…”

Section: Background: the Past And The Futurementioning

confidence: 99%

“…15,29 According to that, the inflammatory trigger in the mesentery stimulates adipocytes and fibroblasts to secrete adipokines and cytokines that in turn perpetuate intestinal inflammation and fibrosis. 15,30 Surgical interest in the mesentery originated in 1982 with observations by Heald that complete removal of the mesentery of the rectum (the mesorectum) during surgery for rectal cancer significantly reduced the risk of local recurrence. 31 The concept of total mesorectal excision (TME) was based on sharp dissection along embryological planes.…”

mentioning

confidence: 99%

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Intriguing Role of the Mesentery in Ileocolic Crohn's Disease

Turri

Carvello

David

et al. 2022

Clin Colon Rectal Surg

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Crohn's disease (CD) is a chronic relapsing inflammatory bowel disease with unknown etiology. Up to 80% of patients will eventually require surgery throughout their lifetime, and often repeated resections are required for disease recurrence. Observations of “creeping fat” surrounding the diseased intestine renewed interest in the mesentery, recently defined as an organ with endocrine and immune functions. According to the inside-out model, the mesentery may be primarily affected in CD and subsequent cause alterations in the mucosa. Recently, lower surgical recurrence rates have been reported with en-bloc excision of the mesentery adjoining the diseased intestine. Results of ongoing randomized controlled trials may clarify the role of the mesentery in CD and possibly lead to its adoption as standard during surgery for Crohn's disease.

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Section: Background: the Past And The Futurementioning

confidence: 99%

mentioning

confidence: 99%

Intriguing Role of the Mesentery in Ileocolic Crohn's Disease

Turri

Carvello

David

et al. 2022

Clin Colon Rectal Surg

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show abstract

“…The risk of developing PAD is consistent with the time from the diagnosis of CD, from 20% after ten years and up to 30% after twenty years. However, PAD is far more common in patients with colon (41%) and rectum (90%) localization and less in patients with ileal disease (12%) [99][100][101][102]. Early diagnosis and correct treatment are crucial to allow patients to promptly start medical treatments with antitumor necrosis factor (tnf) which is considered the cornerstone of treatment, offering the best long-term control of PAD [103][104][105][106][107][108][109][110][111][112][113][114][115][116].…”

Section: Perianal Crohn's Diseasementioning

confidence: 99%

Ambulatory Surgery for Perianal Disease

Divizia¹,

Sica²

2022

Ultimate Guide to Outpatient Care

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The gold standard in the diagnosis and treatment of proctological diseases is the exploration of the anal canal and distal rectum under anaesthesia (EUA), routinely performed as day case surgery. In selected cases it can be conducted as an outpatient exploration (OE) during a specialist surgical consultation. In the outpatient setting it is possible and safe to perform rubber band ligation, sclerotherapy and infrared coagulation for the treatment of haemorrhoidal disease, excision and incision of thrombosed external haemorrhoids, abscess drainage, setonage and fistulotomy also in case of perianal Crohn’s disease, anal warts and skin tags removal. In terms of patients’ satisfaction and success rate OE is comparable to EUA. All procedures can be performed under local anaesthesia. Pain control after the procedure is provided by oral pain killers.

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Section: Perianal Crohn's Diseasementioning

confidence: 99%

Ultimate Guide to Outpatient Care

2022

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Patients who do not require hospitalization or overnight stay in the hospital can be treated via outpatient care; these patients are known as outpatients. Patients who attend appointments at a hospital or clinic for any check-up or aftercare following treatment are also considered outpatients. The popularity of outpatient care has increased because of technological advancements such as minimally invasive surgery. Ear, nose, and throat (ENT), heart, kidney, and orthopedic surgeries can be performed at outpatient facilities because of these new techniques. Technology and patient consumerism are two of the top factors contributing to the growth of outpatient facilities such as ambulatory surgery centers (ASCs), primary care clinics, and urgent care centers, according to Definitive Healthcare's 2019 outpatient trends report. Hospital-based outpatient services can be broadly classified into five main types: clinical, surgical, emergency, home health, and women's health. Other types of outpatient services include school health, office health, outpatient mental health, and others that are newly emerging. Recently, telemedicine-based follow-up has proven to be feasible and safe for the evaluation of early postoperative complications. Patients reported high levels of satisfaction with the experience. As such, telemedicine-based follow-up could become standard practice with the development of mobile applications. One of the most facilitative aspects of outpatient care is that it can be accomplished in non-medical institution-based settings, such as schools, prisons, offices, and more. Outpatient care is likely to become even more popular with the advancement of technology to support it. This work would not have been possible without the support of IntechOpen. I am especially indebted to Author Service Manager Mr. Josip Knapić, who has been supportive of this project and who worked actively to provide me with all facilities. I am grateful to all of those with whom I have had the pleasure to work during this project. Each of the chapter authors provided me with extensive professional help and obliged me on this scientific venture wherever possible. Nobody has been more important to me in the pursuit of this project than the members of my family. I would like to thank my late parents, Taufiquz Zaman and Jaiba Zaman, whose love and guidance are with me in whatever I pursue. Most importantly, I wish to thank my loving and supportive wife, Mrs. Jarin Tanwir Hussain, who is my ultimate role model, and my two wonderful children, Naushad Muntasir Zaman and Umar Sarwar Zaman, who provided me with unending inspiration during the preparation and publication of this book.

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The Role of Active Inflammation and Surgical Therapy in Crohn’s Disease Recurrence

Cited by 5 publications

References 73 publications

Intriguing Role of the Mesentery in Ileocolic Crohn's Disease

Intriguing Role of the Mesentery in Ileocolic Crohn's Disease

Ambulatory Surgery for Perianal Disease

Ultimate Guide to Outpatient Care

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