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复杂的克罗恩病的手术管理
Sarah J Ullrich1, Jason S Frischer1
1Colorectal Center at Cincinnati Children's Hospital, Divison of Pediatric General & Thoracic Surgery, 3333 Burnet Ave, MLC-2024, Cincinnati, OH 45229, USA.
儿科克罗恩病的外科治疗侧重于息治疗,优先考虑肠道长度的保存和解决并发症. 关键考虑因素包括多学科风险评估和特定于儿科患者的生长影响.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 炎症性肠道疾病 炎症性肠病
背景情况:
- 儿科克罗恩病的手术治疗是缓解性,重点关注后果和肠道长度的保存.
- 儿科的考虑包括与成年克罗恩病不同的生长和发育效应.
- 在手术前,对风险和生活质量的多学科评估至关重要.
研究的目的:
- 概述儿童克罗恩病的当前手术策略.
- 突出儿童在克罗恩病管理中的特定挑战.
- 强调一个多学科的方法,以获得最佳的患者结果.
主要方法:
- 对儿科克罗恩病的外科原则的审查.
- 讨论腹腔内和纤维肌狭窄的方法.
- 考虑用于耐火性直肠炎的便转移.
主要成果:
- 皮肤疏通是首选的腹内;手术是为不稳定或耐火病例保留的.
- 对于纤维肌性疾病,建议进行狭窄整形,以最大限度地保持肠道的长度.
- 没有进行直肠切除术的便转移是医疗耐药克罗恩直肠炎的初始方法.
结论:
- 儿科克罗恩病手术需要针对性方法,考虑到生长和发育.
- 保守的措施,如皮肤通道排水和狭窄塑性是有利的.
- 便转移是特定儿科克罗恩氏病呈现的关键策略.
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