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Clin Colon Rectal Surg
DOI: 10.1055/s-0044-1786534
Review Article

Anastomosis after Bowel Resection for Crohn's Disease: State of the Art Review

Carla Newton
1   Division of Colon and Rectal Surgery, Department of Surgery, Baylor Scott & White Medical Center, Baylor College of Medicine, Temple, Texas
,
Alessandro Fichera
2   Division of Colon and Rectal Surgery, Baylor University Medical Center, Texas A&M University, Dallas, Texas
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Abstract

Recurrence after surgically induced remission in Crohn's disease remains a topic of research and debate with significant clinical implications for overall quality of life and intestinal and defecatory functions. While the surgeon continues to play a critical role in surgical prophylaxis of recurrence, optimal results will only be obtained in the setting of a true multidisciplinary team approach, following the principles of “the right surgery, on the right patient, at the right time, performed by the right surgeon, supported by the right team.” The centerpiece of surgical prophylaxis is the intestinal anastomosis. The ideal anastomosis after resection for Crohn's disease should be safe and reliable, as postoperative septic complications have been shown to increase the risk of recurrence; result in a wide lumen and a configuration that would not impede enteric flow; exclude or excise the mesentery, a known culprit in primary and recurrent disease; and preserve vascularization and innervation. This article will review the evidence supporting the above-mentioned surgical principles and the long-term results of the different anastomotic configurations.

Keywords

Crohn's disease - anastomotic techniques - mesentery - microbiome - surgical recurrence


Publication History

Article published online:
02 May 2024

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