Laparoscopic redo surgery in recurrent ileocolic Crohn's disease: A standardised technique
Autor: | Valerio Celentano |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Laparoscopic surgery
medicine.medical_specialty Incisional hernia crohn's disease medicine.medical_treatment lcsh:Surgery Disease 03 medical and health sciences 0302 clinical medicine medicine Bowel function anastomotic recurrence lcsh:RC799-869 Crohn's disease Standardised technique business.industry Cosmesis redo surgery lcsh:RD1-811 medicine.disease laparoscopic surgery ileocolic resection Surgery 030220 oncology & carcinogenesis Redo surgery 030211 gastroenterology & hepatology lcsh:Diseases of the digestive system. Gastroenterology How I do it business |
Zdroj: | Journal of Minimal Access Surgery, Vol 16, Iss 1, Pp 90-93 (2020) Journal of Minimal Access Surgery |
ISSN: | 1998-3921 0972-9941 |
Popis: | Background: Despite many advances in the medical management of Crohn's disease (CD), there is still a significant risk of surgical resection for lack of response to medical management or complications during the lifetime of a patient. Laparoscopic surgery offers short-term benefits such as decreased pain, lower wound complication rates, earlier resumption of diet and bowel function, better cosmesis and shorter hospital stays, while reduced post-operative adhesions and lower incisional hernia rate may represent long-term benefits. Methods: A modular, standardised laparoscopic approach can be applied to safely perform laparoscopic redo surgery in the hostile setting of the recurrent CD and to facilitate teaching and training of these advanced procedures. Results: Laparoscopic surgery in CD can be particularly challenging due to multifocal disease with extensive inflammation and a thickened mesentery, the potential for abscesses, fistulas and phlegmons and high conversion rates have been reported in reoperative surgery for recurrent CD with abscesses and adhesions representing the main reasons for conversion. Conclusions: A standardised laparoscopic approach for redo surgery in recurrent CD has been described. Multidisciplinary management of CD is essential and bowel preservation must be the priority. |
Databáze: | OpenAIRE |
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