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Clin Colon Rectal Surg 2019; 32(04): 249-254
DOI: 10.1055/s-0039-1683906
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Current Status of Segmental Colectomy in Select Crohn's Disease Patients

Alexander Heriot
1   Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
,
Philip Smart
2   Department of Surgery, Austin Health, Melbourne, Victoria, Australia
3   General Surgery and Gastroenterology Clinical Institute, Epworth Healthcare, Melbourne, Victoria, Australia
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Publikationsdatum:
02. Juli 2019 (online)

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Abstract

Crohn's disease is a complex disease with a varying clinical and anatomical spectrum. One-third of patients with Crohn's will have disease confined to the colon. In this article, the authors review the surgical treatment options for colonic Crohn's disease including the current status of performing segmental colectomy in colonic Crohn's, the pros and cons of segmental versus subtotal colectomy, and the influence of biologics on recurrence rates following segmental colectomy.

Keywords

Crohn's disease - colitis - surgical treatment - inflammatory disorder - anti-TNF
 

  • References

  • 1 Torres J, Mehandru S, Colombel JF, Peyrin-Biroulet L. Crohn's disease. Lancet 2017; 389 (10080(: 1741-1755
    CrossrefPubMedSuche in Google Scholar
  • 2 Cosnes J, Cattan S, Blain A. , et al. Long-term evolution of disease behavior of Crohn's disease. Inflamm Bowel Dis 2002; 8 (04) 244-250
    CrossrefPubMedSuche in Google Scholar
  • 3 Thia KT, Sandborn WJ, Harmsen WS, Zinsmeister AR, Loftus Jr EV. Risk factors associated with progression to intestinal complications of Crohn's disease in a population-based cohort. Gastroenterology 2010; 139 (04) 1147-1155
    CrossrefPubMedSuche in Google Scholar
  • 4 Hellers G, Bergstrand O, Ewerth S, Holmström B. Occurrence and outcome after primary treatment of anal fistulae in Crohn's disease. Gut 1980; 21 (06) 525-527
    CrossrefPubMedSuche in Google Scholar
  • 5 Silverberg MS, Satsangi J, Ahmad T. , et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol 2005; 19 (Suppl A): 5A-36A
    CrossrefPubMedSuche in Google Scholar
  • 6 Louis E, Collard A, Oger AF, Degroote E, Aboul Nasr El Yafi FA, Belaiche J. Behaviour of Crohn's disease according to the Vienna classification: changing pattern over the course of the disease. Gut 2001; 49 (06) 777-782
    CrossrefPubMedSuche in Google Scholar
  • 7 Mowat C, Cole A, Windsor A. , et al; IBD Section of the British Society of Gastroenterology. Guidelines for the management of inflammatory bowel disease in adults. Gut 2011; 60 (05) 571-607
    CrossrefPubMedSuche in Google Scholar
  • 8 Dignass A, Van Assche G, Lindsay JO. , et al; European Crohn's and Colitis Organisation (ECCO). The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: current management. J Crohns Colitis 2010; 4 (03) 353
    CrossrefPubMedSuche in Google Scholar
  • 9 Prudhomme M, Dehni N, Dozois RR, Tiret E, Parc R. Causes and outcomes of pouch excision after restorative proctocolectomy. Br J Surg 2006; 93 (01) 82-86
    CrossrefPubMedSuche in Google Scholar
  • 10 Bernell O, Lapidus A, Hellers G. Risk factors for surgery and postoperative recurrence in Crohn's disease. Ann Surg 2000; 231 (01) 38-45
    CrossrefPubMedSuche in Google Scholar
  • 11 Longo WE, Ballantyne GH, Cahow CE. ; W.E. L. Treatment of Crohn's colitis. Segmental or total colectomy?. Arch Surg 1988; 123 (05) 588-590
    PubMedSuche in Google Scholar
  • 12 Tekkis PP, Purkayastha S, Lanitis S. , et al. A comparison of segmental vs subtotal/total colectomy for colonic Crohn's disease: a meta-analysis. Colorectal Dis 2006; 8 (02) 82-90
    CrossrefPubMedSuche in Google Scholar
  • 13 Prabhakar LP, Wolff BG. Crohn's colitis. In: Fazio VW, Church JM, Delaney CP. , eds. Current Therapy in Colon and Rectal Surgery. 2nd ed. Pennsylvania: Elsevier Mosby; 2005
    Suche in Google Scholar
  • 14 Olaison G, Sjödahl R. Operations for Crohn's colitis: limited resection and preservation of anorectal function. Eur J Surg 1998; 164 (12) 917-925
    PubMedSuche in Google Scholar
  • 15 Guy TS, Williams NN, Rosato EF. Crohn's disease of the colon. Surg Clin North Am 2001; 81 (01) 159-168 , ix
    CrossrefPubMedSuche in Google Scholar
  • 16 Morini S, Hassan C, Lorenzetti R. , et al. Long-term outcome of endoscopic pneumatic dilatation in Crohn's disease. Dig Liver Dis 2003; 35 (12) 893-897
    CrossrefPubMedSuche in Google Scholar
  • 17 Prabhakar LP, Laramee C, Nelson H, Dozois RR. Avoiding a stoma: role for segmental or abdominal colectomy in Crohn's colitis. Dis Colon Rectum 1997; 40 (01) 71-78
    CrossrefPubMedSuche in Google Scholar
  • 18 Holubar SD, Wolff BG, Poola VP, Soop M. Multiple synchronous colonic anastomoses: are they safe?. Colorectal Dis 2010; 12 (02) 135-140
    CrossrefPubMedSuche in Google Scholar
  • 19 NICE. Crohn's disease: management. 2016. Available at https://www.nice.org.uk/guidance/cg152 . Accessed on May 11, 2019
    PubMed
  • 20 Strong S, Steele SR, Boutrous M. , et al; Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. Clinical practice guideline for the surgical management of Crohn's disease. Dis Colon Rectum 2015; 58 (11) 1021-1036
    CrossrefPubMedSuche in Google Scholar
  • 21 Strong S. Surgical management of Crohn's disease. In: Holzheimer RG, Mannick JA. , eds. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001
    Suche in Google Scholar
  • 22 Strong S. Surgery for Crohn disease. In: Bailey HR, Billingham RP, Stamos MJ, Snyder MJ. , eds. Colorectal Surgery. Philadelphia, PA: Elsevier Saunders; 2013
    Suche in Google Scholar
  • 23 Keighley MR, Buchmann P, Lee JR. Assessment of anorectal function in selection of patients for ileorectal anastomosis in Crohn's colitis. Gut 1982; 23 (02) 102-107
    CrossrefPubMedSuche in Google Scholar
  • 24 Colombel JF, Sandborn WJ, Reinisch W. , et al; SONIC Study Group. Infliximab, azathioprine, or combination therapy for Crohn's disease. N Engl J Med 2010; 362 (15) 1383-1395
    CrossrefPubMedSuche in Google Scholar
  • 25 Doherty G, Bennett G, Patil S, Cheifetz A, Moss AC. Interventions for prevention of post-operative recurrence of Crohn's disease. Cochrane Database Syst Rev 2009; (04) CD006873
    PubMedSuche in Google Scholar
  • 26 D'haens G, Van Deventer S, Van Hogezand R. , et al. Endoscopic and histological healing with infliximab anti-tumor necrosis factor antibodies in Crohn's disease: a European multicenter trial. Gastroenterology 1999; 116 (05) 1029-1034
    CrossrefPubMedSuche in Google Scholar
  • 27 Antunes O, Filippi J, Hébuterne X, Peyrin-Biroulet L. Treatment algorithms in Crohn's - up, down or something else?. Best Pract Res Clin Gastroenterol 2014; 28 (03) 473-483
    CrossrefPubMedSuche in Google Scholar
  • 28 Geboes K, Rutgeerts P, Opdenakker G. , et al. Endoscopic and histologic evidence of persistent mucosal healing and correlation with clinical improvement following sustained infliximab treatment for Crohn's disease. Curr Med Res Opin 2005; 21 (11) 1741-1754
    CrossrefPubMedSuche in Google Scholar
  • 29 Hanauer SB, Feagan BG, Lichtenstein GR. , et al; ACCENT I Study Group. Maintenance infliximab for Crohn's disease: the ACCENT I randomised trial. Lancet 2002; 359 (9317): 1541-1549
    CrossrefPubMedSuche in Google Scholar
  • 30 Oh EH, Oh K, Han M. , et al. Early anti-TNF/immunomodulator therapy is associated with better long-term clinical outcomes in Asian patients with Crohn's disease with poor prognostic factors. PLoS One 2017; 12 (05) e0177479
    CrossrefPubMedSuche in Google Scholar
  • 31 Shah SC, Colombel JF, Sands BE, Narula N. Systematic review with meta-analysis: mucosal healing is associated with improved long-term outcomes in Crohn's disease. Aliment Pharmacol Ther 2016; 43 (03) 317-333
    CrossrefPubMedSuche in Google Scholar
  • 32 Colombel JF, Sandborn WJ, Rutgeerts P. , et al. Adalimumab for maintenance of clinical response and remission in patients with Crohn's disease: the CHARM trial. Gastroenterology 2007; 132 (01) 52-65
    CrossrefPubMedSuche in Google Scholar
  • 33 Sandborn WJ, Feagan BG, Stoinov S. , et al; PRECISE 1 Study Investigators. Certolizumab pegol for the treatment of Crohn's disease. N Engl J Med 2007; 357 (03) 228-238
    CrossrefPubMedSuche in Google Scholar
  • 34 Marehbian J, Arrighi HM, Hass S, Tian H, Sandborn WJ. Adverse events associated with common therapy regimens for moderate-to-severe Crohn's disease. Am J Gastroenterol 2009; 104 (10) 2524-2533
    CrossrefPubMedSuche in Google Scholar
  • 35 Mackey AC, Green L, Liang LC, Dinndorf P, Avigan M. Hepatosplenic T cell lymphoma associated with infliximab use in young patients treated for inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2007; 44 (02) 265-267
    CrossrefPubMedSuche in Google Scholar
  • 36 Lichtenstein GR, Feagan BG, Cohen RD. , et al. Serious infections and mortality in association with therapies for Crohn's disease: TREAT registry. Clin Gastroenterol Hepatol 2006; 4 (05) 621-630
    CrossrefPubMedSuche in Google Scholar
  • 37 Peyrin-Biroulet L, Fiorino G, Buisson A, Danese S. First-line therapy in adult Crohn's disease: who should receive anti-TNF agents?. Nat Rev Gastroenterol Hepatol 2013; 10 (06) 345-351
    PubMedSuche in Google Scholar
  • 38 Khanna R, Bressler B, Levesque BG. , et al; REACT Study Investigators. Early combined immunosuppression for the management of Crohn's disease (REACT): a cluster randomised controlled trial. Lancet 2015; 386 (10006): 1825-1834
    CrossrefPubMedSuche in Google Scholar
  • 39 Feagan BG, Lémann M, Befrits R. , et al. Recommendations for the treatment of Crohn's disease with tumor necrosis factor antagonists: an expert consensus report. Inflamm Bowel Dis 2012; 18 (01) 152-160
    CrossrefPubMedSuche in Google Scholar
  • 40 Rubenstein JH, Chong RY, Cohen RD. Infliximab decreases resource use among patients with Crohn's disease. J Clin Gastroenterol 2002; 35 (02) 151-156
    CrossrefPubMedSuche in Google Scholar
  • 41 Ramadas AV, Gunesh S, Thomas GA, Williams GT, Hawthorne AB. Natural history of Crohn's disease in a population-based cohort from Cardiff (1986-2003): a study of changes in medical treatment and surgical resection rates. Gut 2010; 59 (09) 1200-1206
    CrossrefPubMedSuche in Google Scholar
  • 42 Slattery E, Keegan D, Hyland J, O'donoghue D, Mulcahy HE. Surgery, Crohn's disease, and the biological era: has there been an impact?. J Clin Gastroenterol 2011; 45 (08) 691-693
    CrossrefPubMedSuche in Google Scholar
  • 43 Jones DW, Finlayson SR. Trends in surgery for Crohn's disease in the era of infliximab. Ann Surg 2010; 252 (02) 307-312
    CrossrefPubMedSuche in Google Scholar
  • 44 Cosnes J, Nion-Larmurier I, Beaugerie L, Afchain P, Tiret E, Gendre JP. Impact of the increasing use of immunosuppressants in Crohn's disease on the need for intestinal surgery. Gut 2005; 54 (02) 237-241
    CrossrefPubMedSuche in Google Scholar
  • 45 Nguyen GC, Tuskey A, Dassopoulos T, Harris ML, Brant SR. Rising hospitalization rates for inflammatory bowel disease in the United States between 1998 and 2004. Inflamm Bowel Dis 2007; 13 (12) 1529-1535
    CrossrefPubMedSuche in Google Scholar
  • 46 Burke JP, Velupillai Y, O'Connell PR, Coffey JC. National trends in intestinal resection for Crohn's disease in the post-biologic era. Int J Colorectal Dis 2013; 28 (10) 1401-1406
    CrossrefPubMedSuche in Google Scholar
  • 47 Alsaleh A, Gaidos JK, Kang L, Kuemmerle JF. Timing of last preoperative dose of infliximab does not increase postoperative complications in inflammatory bowel disease patients. Dig Dis Sci 2016; 61 (09) 2602-2607
    CrossrefPubMedSuche in Google Scholar
  • 48 Narula N, Charleton D, Marshall JK. Meta-analysis: peri-operative anti-TNFα treatment and post-operative complications in patients with inflammatory bowel disease. Aliment Pharmacol Ther 2013; 37 (11) 1057-1064
    CrossrefPubMedSuche in Google Scholar
  • 49 Billioud V, Ford AC, Tedesco ED, Colombel JF, Roblin X, Peyrin-Biroulet L. Preoperative use of anti-TNF therapy and postoperative complications in inflammatory bowel diseases: a meta-analysis. J Crohn's Colitis 2013; 7 (11) 853-867
    PubMedSuche in Google Scholar
  • 50 Kopylov U, Ben-Horin S, Zmora O, Eliakim R, Katz LH. Anti-tumor necrosis factor and postoperative complications in Crohn's disease: systematic review and meta-analysis. Inflamm Bowel Dis 2012; 18 (12) 2404-2413
    CrossrefPubMedSuche in Google Scholar
  • 51 Appau KA, Fazio VW, Shen B. , et al. Use of infliximab within 3 months of ileocolonic resection is associated with adverse postoperative outcomes in Crohn's patients. J Gastrointest Surg 2008; 12 (10) 1738-1744
    CrossrefPubMedSuche in Google Scholar
  • 52 Yang ZP, Hong L, Wu Q, Wu KC, Fan DM. Preoperative infliximab use and postoperative complications in Crohn's disease: a systematic review and meta-analysis. Int J Surg 2014; 12 (03) 224-230
    CrossrefPubMedSuche in Google Scholar
  • 53 Lau C, Dubinsky M, Melmed G. , et al. The impact of preoperative serum anti-TNFα therapy levels on early postoperative outcomes in inflammatory bowel disease surgery. Ann Surg 2015; 261 (03) 487-496
    CrossrefPubMedSuche in Google Scholar
  • 54 Uchino M, Ikeuchi H, Matsuoka H. , et al. Risk factors for surgical site infection and association with infliximab administration during surgery for Crohn's disease. Dis Colon Rectum 2013; 56 (10) 1156-1165
    CrossrefPubMedSuche in Google Scholar
  • 55 Colombel JF, Loftus Jr EV, Tremaine WJ. , et al. Early postoperative complications are not increased in patients with Crohn's disease treated perioperatively with infliximab or immunosuppressive therapy. Am J Gastroenterol 2004; 99 (05) 878-883
    CrossrefPubMedSuche in Google Scholar
  • 56 Peyrin-Biroulet L, Reinisch W, Colombel JF. , et al. Clinical disease activity, C-reactive protein normalisation and mucosal healing in Crohn's disease in the SONIC trial. Gut 2014; 63 (01) 88-95
    CrossrefPubMedSuche in Google Scholar
  • 57 Pariente B, Cosnes J, Danese S. , et al. Development of the Crohn's disease digestive damage score, the Lémann score. Inflamm Bowel Dis 2011; 17 (06) 1415-1422
    CrossrefPubMedSuche in Google Scholar
  • 58 Siegel CA, Whitman CB, Spiegel BMR. , et al. Development of an index to define overall disease severity in IBD. Gut 2018; 67 (02) 244-254
    CrossrefPubMedSuche in Google Scholar