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Surgical treatment of intestinal stricture in inflammatory bowel disease.

Abstract：

:Fibroblast infiltration and collagen deposition result in structural changes in the bowel wall, and lead to strictures in intestinal inflammatory disease. While strictures can also occur in other contexts, such as malignancy, this review focuses on the surgical treatment of stricture secondary to inflammatory bowel disease. Distinguishing between predominantly inflammation vs established fibrosis as the cause of a stricture can be challenging. While inflammatory strictures may be responsive to medication, predominantly fibrotic strictures usually need surgical intervention. Both endoluminal and extraluminal approaches are described in this review. Endoscopic dilatation of strictures is suitable for short-segment isolated small bowel strictures. Other options are to divide the stricture surgically but preserve the length, performing a strictureplasty or resecting the strictured segment. The mesentery is increasingly recognized as playing a role in stricture recurrence. In a relapsing-remitting disease such as Crohn's disease, the preservation of intestinal length is essential and balance is needed between this and a complete resection to reduce the risk of recurrence. Pre- and postoperative involvement of the multidisciplinary team is essential to improve outcomes in this challenging clinical scenario.

journal_name

J Dig Dis

journal_title

Journal of digestive diseases

authors

Mohan HM,Coffey JC

doi

10.1111/1751-2980.12880

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

355-359

issue

6

eissn

1751-2972

issn

1751-2980

journal_volume

21

pub_type

杂志文章,评审

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