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Clin Colon Rectal Surg 2018; 31(02): 080-088
DOI: 10.1055/s-0037-1609022
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pediatric Crohn's Disease

Daniel von Allmen
1   Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Publication Date:
25 February 2018 (online)

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Abstract

The incidence of Crohn's disease in the pediatric population is increasing. While pediatric patients with Crohn's disease exhibit many of the characteristics of older patients, there are important differences in the clinical presentation and course of disease that can impact the clinical decisions made during treatment. The majority of children are diagnosed in the early teen years, but subgroups of very early onset and infantile Crohn's present much earlier and have a unique clinical course. Treatment paradigms follow the traditional laddered approach, but growth and development represent special considerations that must be given to pediatric-specific complications of the treatment and disease. Surgical intervention is an important component of Crohn's management and is often employed to allow improved nutritional intake or decrease reliance on medical treatments that compromise growth.

Keywords

pediatric - Crohn's disease - nutritional therapy - surgery
 

  • References

  • 1 Benchimol EI, Fortinsky KJ, Gozdyra P, Van den Heuvel M, Van Limbergen J, Griffiths AM. Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflamm Bowel Dis 2011; 17 (01) 423-439
    CrossrefPubMedSearch in Google Scholar
  • 2 Kappelman MD, Rifas-Shiman SL, Kleinman K. , et al. The prevalence and geographic distribution of Crohn's disease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol 2007; 5 (12) 1424-1429
    CrossrefPubMedSearch in Google Scholar
  • 3 Debruyn JC, Soon IS, Hubbard J, Wrobel I, Panaccione R, Kaplan GG. Nationwide temporal trends in incidence of hospitalization and surgical intestinal resection in pediatric inflammatory bowel diseases in the United States from 1997 to 2009. Inflamm Bowel Dis 2013; 19 (11) 2423-2432
    CrossrefPubMedSearch in Google Scholar
  • 4 Snapper SB. Very-early-onset inflammatory bowel disease. Gastroenterol Hepatol (N Y) 2015; 11 (08) 554-556
    PubMedSearch in Google Scholar
  • 5 Pigneur B, Seksik P, Viola S. , et al. Natural history of Crohn's disease: comparison between childhood- and adult-onset disease. Inflamm Bowel Dis 2010; 16 (06) 953-961
    CrossrefPubMedSearch in Google Scholar
  • 6 Gupta N, Bostrom AG, Kirschner BS. , et al. Presentation and disease course in early-compared to later-onset pediatric Crohn's disease. Am J Gastroenterol 2008; 103 (08) 2092-2098
    CrossrefPubMedSearch in Google Scholar
  • 7 DeBoer MD, Denson LA. Delays in puberty, growth, and accrual of bone mineral density in pediatric Crohn's disease: despite temporal changes in disease severity, the need for monitoring remains. J Pediatr 2013; 163 (01) 17-22
    CrossrefPubMedSearch in Google Scholar
  • 8 Tillack C, Seiderer J, Brand S. , et al. Correlation of magnetic resonance enteroclysis (MRE) and wireless capsule endoscopy (CE) in the diagnosis of small bowel lesions in Crohn's disease. Inflamm Bowel Dis 2008; 14 (09) 1219-1228
    CrossrefPubMedSearch in Google Scholar
  • 9 Siddiki HA, Fidler JL, Fletcher JG. , et al. Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn's disease. AJR Am J Roentgenol 2009; 193 (01) 113-121
    CrossrefPubMedSearch in Google Scholar
  • 10 de Bie CI, Paerregaard A, Kolacek S. , et al; EUROKIDS Porto IBD Working Group of ESPGHAN. Disease phenotype at diagnosis in pediatric Crohn's disease: 5-year analyses of the EUROKIDS Registry. Inflamm Bowel Dis 2013; 19 (02) 378-385
    CrossrefPubMedSearch in Google Scholar
  • 11 Escher JC. Mucosal healing in pediatric Crohn's disease: Pro/Con balance. Inflamm Bowel Dis 2004; 10 (04) 484
    CrossrefPubMedSearch in Google Scholar
  • 12 Bousvaros A. Mucosal healing in children with Crohn's disease: appropriate therapeutic goal or medical overkill?. Inflamm Bowel Dis 2004; 10 (04) 481-483
    CrossrefPubMedSearch in Google Scholar
  • 13 Ruemmele FM, Veres G, Kolho KL. , et al; European Crohn's and Colitis Organisation; European Society of Pediatric Gastroenterology, Hepatology and Nutrition. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn's disease. J Crohn's Colitis 2014; 8 (10) 1179-1207
    PubMedSearch in Google Scholar
  • 14 Gupta K, Noble A, Kachelries KE. , et al. A novel enteral nutrition protocol for the treatment of pediatric Crohn's disease. Inflamm Bowel Dis 2013; 19 (07) 1374-1378
    CrossrefPubMedSearch in Google Scholar
  • 15 Markowitz J, Grancher K, Kohn N, Lesser M, Daum F. A multicenter trial of 6-mercaptopurine and prednisone in children with newly diagnosed Crohn's disease. Gastroenterology 2000; 119 (04) 895-902
    CrossrefPubMedSearch in Google Scholar
  • 16 Alfadhli AA, McDonald JW, Feagan BG. Methotrexate for induction of remission in refractory Crohn's disease. Cochrane Database Syst Rev 2005; (01) CD003459
    PubMedSearch in Google Scholar
  • 17 Hyams J, Crandall W, Kugathasan S. , et al; REACH Study Group. Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn's disease in children. Gastroenterology 2007; 132 (03) 863-873 , quiz 1165–1166
    CrossrefPubMedSearch in Google Scholar
  • 18 Ferrari L, Krane MK, Fichera A. Inflammatory bowel disease surgery in the biologic era. World J Gastrointest Surg 2016; 8 (05) 363-370
    CrossrefPubMedSearch in Google Scholar
  • 19 Abbas PI, Peterson ML, Fallon SC. , et al. Evaluating the impact of infliximab use on surgical outcomes in pediatric Crohn's disease. J Pediatr Surg 2016; 51 (05) 786-789
    CrossrefPubMedSearch in Google Scholar
  • 20 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
    CrossrefPubMedSearch in Google Scholar
  • 21 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
    CrossrefPubMedSearch in Google Scholar
  • 22 Griffiths AM, Alemayehu E, Sherman P. Clinical features of gastroduodenal Crohn disease in adolescents. J Pediatr Gastroenterol Nutr 1989; 86: 259-262
    PubMedSearch in Google Scholar
  • 23 Dziki A, Galbfach P. Crohn's disease--when to operate?. Acta Chir Iugosl 2004; 51 (02) 61-68
    PubMedSearch in Google Scholar
  • 24 McLeod RS. Surgery for inflammatory bowel diseases. Dig Dis 2003; 21 (02) 168-179
    CrossrefPubMedSearch in Google Scholar
  • 25 Veroux M, Angriman I, Ruffolo C. , et al. Severe gastrointestinal bleeding in Crohn's disease. Ann Ital Chir 2003; 74 (02) 213-215 , discussion 216
    PubMedSearch in Google Scholar
  • 26 Andersson P, Olaison G, Bodemar G, Nyström PO, Sjödahl R. Surgery for Crohn colitis over a twenty-eight-year period: fewer stomas and the replacement of total colectomy by segmental resection. Scand J Gastroenterol 2002; 37 (01) 68-73
    CrossrefPubMedSearch in Google Scholar
  • 27 Hurst RD, Molinari M, Chung TP, Rubin M, Michelassi F. Prospective study of the features, indications, and surgical treatment in 513 consecutive patients affected by Crohn's disease. Surgery 1997; 122 (04) 661-667 , discussion 667–668
    CrossrefPubMedSearch in Google Scholar
  • 28 Alvarez-Lobos M, Arostegui JI, Sans M. , et al. Crohn's disease patients carrying Nod2/CARD15 gene variants have an increased and early need for first surgery due to stricturing disease and higher rate of surgical recurrence. Ann Surg 2005; 242 (05) 693-700
    CrossrefPubMedSearch in Google Scholar
  • 29 Mazor Y, Maza I, Kaufman E. , et al. Prediction of disease complication occurrence in Crohn's disease using phenotype and genotype parameters at diagnosis. J Crohn's Colitis 2011; 5 (06) 592-597
    PubMedSearch in Google Scholar
  • 30 Rufo PA, Bousvaros A. Current therapy of inflammatory bowel disease in children. Paediatr Drugs 2006; 8 (05) 279-302
    CrossrefPubMedSearch in Google Scholar
  • 31 Patel HI, Leichtner AM, Colodny AH, Shamberger RC. Surgery for Crohn's disease in infants and children. J Pediatr Surg 1997; 32 (07) 1063-1067 , discussion 1067–1068
    CrossrefPubMedSearch in Google Scholar
  • 32 Dokucu AI, Sarnacki S, Michel JL. , et al. Indications and results of surgery in patients with Crohn's disease with onset under 10 years of age: a series of 18 patients. Eur J Pediatr Surg 2002; 12 (03) 180-185
    Thieme ConnectPubMedSearch in Google Scholar
  • 33 Konno M, Kobayashi A, Tomomasa T. , et al; Working Group of the Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition. Guidelines for the treatment of Crohn's disease in children. Pediatr Int 2006; 48 (03) 349-352
    CrossrefPubMedSearch in Google Scholar
  • 34 Heuschkel R, Salvestrini C, Beattie RM, Hildebrand H, Walters T, Griffiths A. Guidelines for the management of growth failure in childhood inflammatory bowel disease. Inflamm Bowel Dis 2008; 14 (06) 839-849
    CrossrefPubMedSearch in Google Scholar
  • 35 Andersson P, Olaison G, Hallböök O, Sjödahl R. Segmental resection or subtotal colectomy in Crohn's colitis?. Dis Colon Rectum 2002; 45 (01) 47-53
    CrossrefPubMedSearch in Google Scholar
  • 36 Martel P, Betton PO, Gallot D, Malafosse M. Crohn's colitis: experience with segmental resections; results in a series of 84 patients. J Am Coll Surg 2002; 194 (04) 448-453
    CrossrefPubMedSearch in Google Scholar
  • 37 Ruffolo C, Angriman I, Scarpa M. , et al. Urologic complications in Crohn's disease: suspicion criteria. Hepatogastroenterology 2006; 53 (69) 357-360
    PubMedSearch in Google Scholar
  • 38 Solem CA, Loftus Jr EV, Tremaine WJ, Pemberton JH, Wolff BG, Sandborn WJ. Fistulas to the urinary system in Crohn's disease: clinical features and outcomes. Am J Gastroenterol 2002; 97 (09) 2300-2305
    CrossrefPubMedSearch in Google Scholar
  • 39 Present DH. Urinary tract fistulas in Crohn's disease: surgery versus medical therapy. Am J Gastroenterol 2002; 97 (09) 2165-2167
    CrossrefPubMedSearch in Google Scholar
  • 40 Gruner JS, Sehon JK, Johnson LW. Diagnosis and management of enterovesical fistulas in patients with Crohn's disease. Am Surg 2002; 68 (08) 714-719
    PubMedSearch in Google Scholar
  • 41 Ben-Ami H, Ginesin Y, Behar DM, Fischer D, Edoute Y, Lavy A. Diagnosis and treatment of urinary tract complications in Crohn's disease: an experience over 15 years. Can J Gastroenterol 2002; 16 (04) 225-229
    CrossrefPubMedSearch in Google Scholar
  • 42 Akobeng AK, Suresh-Babu MV, Firth D, Miller V, Mir P, Thomas AG. Quality of life in children with Crohn's disease: a pilot study. J Pediatr Gastroenterol Nutr 1999; 28 (04) S37-S39
    CrossrefPubMedSearch in Google Scholar
  • 43 Berg DF, Bahadursingh AM, Kaminski DL, Longo WE. Acute surgical emergencies in inflammatory bowel disease. Am J Surg 2002; 184 (01) 45-51
    CrossrefPubMedSearch in Google Scholar
  • 44 Galandiuk S, Kimberling J, Al-Mishlab TG, Stromberg AJ. Perianal Crohn disease: predictors of need for permanent diversion. Ann Surg 2005; 241 (05) 796-801 , discussion 801–802
    CrossrefPubMedSearch in Google Scholar
  • 45 Ecker KW, Gierend M, Kreissler-Haag D, Feifel G. Reoperations at the ileostomy in Crohn's disease reflect inflammatory activity rather than surgical stoma complications alone. Int J Colorectal Dis 2001; 16 (02) 76-80
    CrossrefPubMedSearch in Google Scholar
  • 46 Froehlich F, Juillerat P, Mottet C. , et al. Obstructive fibrostenotic Crohn's disease. Digestion 2005; 71 (01) 29-30
    CrossrefPubMedSearch in Google Scholar
  • 47 Karaoglu AO, Yukselen V. Obstructing Crohn's disease of the duodenum: is surgery always mandatory?. Int J Clin Pract 2004; 58 (02) 221-223
    CrossrefPubMedSearch in Google Scholar
  • 48 Heimann TM, Greenstein AJ, Lewis B, Kaufman D, Heimann DM, Aufses Jr AH. Comparison of primary and reoperative surgery in patients with Crohns disease. Ann Surg 1998; 227 (04) 492-495
    CrossrefPubMedSearch in Google Scholar
  • 49 Glehen O, Lifante JC, Vignal J. , et al. Small bowel length in Crohn's disease. Int J Colorectal Dis 2003; 18 (05) 423-427
    CrossrefPubMedSearch in Google Scholar
  • 50 Yamamoto T, Bain IM, Mylonakis E, Allan RN, Keighley MR. Stapled functional end-to-end anastomosis versus sutured end-to-end anastomosis after ileocolonic resection in Crohn disease. Scand J Gastroenterol 1999; 34 (07) 708-713
    CrossrefPubMedSearch in Google Scholar
  • 51 Ikeuchi H, Kusunoki M, Yamamura T. Long-term results of stapled and hand-sewn anastomoses in patients with Crohn's disease. Dig Surg 2000; 17 (05) 493-496
    CrossrefPubMedSearch in Google Scholar
  • 52 Tersigni R, Alessandroni L, Barreca M, Piovanello P, Prantera C. Does stapled functional end-to-end anastomosis affect recurrence of Crohn's disease after ileocolonic resection?. Hepatogastroenterology 2003; 50 (53) 1422-1425
    PubMedSearch in Google Scholar
  • 53 Yamamoto T. Factors affecting recurrence after surgery for Crohn's disease. World J Gastroenterol 2005; 11 (26) 3971-3979
    CrossrefPubMedSearch in Google Scholar
  • 54 Resegotti A, Astegiano M, Farina EC. , et al. Side-to-side stapled anastomosis strongly reduces anastomotic leak rates in Crohn's disease surgery. Dis Colon Rectum 2005; 48 (03) 464-468
    CrossrefPubMedSearch in Google Scholar
  • 55 Larson DW, Pemberton JH. Current concepts and controversies in surgery for IBD. Gastroenterology 2004; 126 (06) 1611-1619
    CrossrefPubMedSearch in Google Scholar
  • 56 Muñoz-Juárez M, Yamamoto T, Wolff BG, Keighley MR. Wide-lumen stapled anastomosis vs. conventional end-to-end anastomosis in the treatment of Crohn's disease. Dis Colon Rectum 2001; 44 (01) 20-25 , discussion 25–26
    CrossrefPubMedSearch in Google Scholar
  • 57 Yamamoto T, Allan RN, Keighley MR. Strategy for surgical management of ileocolonic anastomotic recurrence in Crohn's disease. World J Surg 1999; 23 (10) 1055-1060 , discussion 1060–1061
    CrossrefPubMedSearch in Google Scholar
  • 58 Cunningham MF, Docherty NG, Coffey JC, Burke JP, O'Connell PR. Postsurgical recurrence of ileal Crohn's disease: an update on risk factors and intervention points to a central role for impaired host-microflora homeostasis. World J Surg 2010; 34 (07) 1615-1626
    CrossrefPubMedSearch in Google Scholar
  • 59 Scarpa M, Angriman I, Barollo M. , et al. Role of stapled and hand-sewn anastomoses in recurrence of Crohn's disease. Hepatogastroenterology 2004; 51 (58) 1053-1057
    PubMedSearch in Google Scholar
  • 60 Yamamoto T, Keighley MR. Stapled functional end-to-end anastomosis in Crohn's disease. Surg Today 1999; 29 (07) 679-681
    CrossrefPubMedSearch in Google Scholar
  • 61 Galandiuk S. Stapled and hand-sewn anastomoses in Crohn's disease. Dig Surg 1998; 15 (06) 655
    CrossrefPubMedSearch in Google Scholar
  • 62 Hashemi M, Novell JR, Lewis AA. Side-to-side stapled anastomosis may delay recurrence in Crohn's disease. Dis Colon Rectum 1998; 41 (10) 1293-1296
    CrossrefPubMedSearch in Google Scholar
  • 63 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
    CrossrefPubMedSearch in Google Scholar
  • 64 Romeo E, Jasonni V, Caldaro T. , et al. Strictureplasty and intestinal resection: different options in complicated pediatric-onset Crohn disease. J Pediatr Surg 2012; 47 (05) 944-948
    CrossrefPubMedSearch in Google Scholar
  • 65 Dietz DW, Fazio VW, Laureti S. , et al. Strictureplasty in diffuse Crohn's jejunoileitis: safe and durable. Dis Colon Rectum 2002; 45 (06) 764-770
    CrossrefPubMedSearch in Google Scholar
  • 66 Laurent S, Detry O, Detroz B. , et al. Strictureplasty in Crohn's disease: short- and long-term follow-up. Acta Chir Belg 2002; 102 (04) 253-255
    PubMedSearch in Google Scholar
  • 67 Dasari BV, Maxwell R, Gardiner KR. Assessment of complications following strictureplasty for small bowel Crohn's Disease. Ir J Med Sci 2010; 179 (02) 201-205
    CrossrefPubMedSearch in Google Scholar
  • 68 Hurst RD, Michelassi F. Strictureplasty for Crohn's disease: techniques and long-term results. World J Surg 1998; 22 (04) 359-363
    CrossrefPubMedSearch in Google Scholar
  • 69 Milsom JW, Hammerhofer KA, Böhm B, Marcello P, Elson P, Fazio VW. Prospective, randomized trial comparing laparoscopic vs. conventional surgery for refractory ileocolic Crohn's disease. Dis Colon Rectum 2001; 44 (01) 1-8 , discussion 8–9
    CrossrefPubMedSearch in Google Scholar
  • 70 Dutta S, Rothenberg SS, Chang J, Bealer J. Total intracorporeal laparoscopic resection of Crohn's disease. J Pediatr Surg 2003; 38 (05) 717-719
    CrossrefPubMedSearch in Google Scholar
  • 71 Tilney HS, Constantinides VA, Heriot AG. , et al. Comparison of laparoscopic and open ileocecal resection for Crohn's disease: a metaanalysis. Surg Endosc 2006; 20 (07) 1036-1044
    CrossrefPubMedSearch in Google Scholar
  • 72 Bonnard A, Fouquet V, Berrebi D. , et al. Crohn's disease in children. Preliminary experience with a laparoscopic approach. Eur J Pediatr Surg 2006; 16 (02) 90-93
    Thieme ConnectPubMedSearch in Google Scholar
  • 73 Maartense S, Dunker MS, Slors JF. , et al. Laparoscopic-assisted versus open ileocolic resection for Crohn's disease: a randomized trial. Ann Surg 2006; 243 (02) 143-149 , discussion 150–153
    CrossrefPubMedSearch in Google Scholar
  • 74 Casillas S, Delaney CP. Laparoscopic surgery for inflammatory bowel disease. Dig Surg 2005; 22 (03) 135-142
    CrossrefPubMedSearch in Google Scholar
  • 75 Hirayama I, Ide M, Shoji H. , et al. Laparoscopic-assisted partial ileectomy for crohn's disease associated with chronic anemia due to frequent hemorrhage. Hepatogastroenterology 2005; 52 (63) 823-825
    PubMedSearch in Google Scholar
  • 76 Huilgol RL, Wright CM, Solomon MJ. Laparoscopic versus open ileocolic resection for Crohn's disease. J Laparoendosc Adv Surg Tech A 2004; 14 (02) 61-65
    CrossrefPubMedSearch in Google Scholar
  • 77 von Allmen D, Markowitz JE, York A, Mamula P, Shepanski M, Baldassano R. Laparoscopic-assisted bowel resection offers advantages over open surgery for treatment of segmental Crohn's disease in children. J Pediatr Surg 2003; 38 (06) 963-965
    CrossrefPubMedSearch in Google Scholar
  • 78 Shore G, Gonzalez QH, Bondora A, Vickers SM. Laparoscopic vs conventional ileocolectomy for primary Crohn disease. Arch Surg 2003; 138 (01) 76-79
    CrossrefPubMedSearch in Google Scholar
  • 79 Dasari BV, McKay D, Gardiner K. Laparoscopic versus open surgery for small bowel Crohn's disease. Cochrane Database Syst Rev 2011; (01) CD006956
    PubMedSearch in Google Scholar
  • 80 Diamond IR, Gerstle JT, Kim PC, Langer JC. Outcomes after laparoscopic surgery in children with inflammatory bowel disease. Surg Endosc 2010; 24 (11) 2796-2802
    CrossrefPubMedSearch in Google Scholar
  • 81 Zaghiyan KN, Murrell Z, Fleshner PR. Scarless single-incision laparoscopic loop ileostomy: a novel technique. Dis Colon Rectum 2011; 54 (12) 1542-1546
    CrossrefPubMedSearch in Google Scholar
  • 82 Wu JS, Birnbaum EH, Kodner IJ, Fry RD, Read TE, Fleshman JW. Laparoscopic-assisted ileocolic resections in patients with Crohn's disease: are abscesses, phlegmons, or recurrent disease contraindications?. Surgery 1997; 122 (04) 682-688 , discussion 688–689
    CrossrefPubMedSearch in Google Scholar
  • 83 Milsom JW. Laparoscopic surgery in the treatment of Crohn's disease. Surg Clin North Am 2005; 85 (01) 25-34 , vii
    CrossrefPubMedSearch in Google Scholar
  • 84 Seymour NE, Kavic SM. Laparoscopic management of complex Crohn's disease. JSLS 2003; 7 (02) 117-121
    PubMedSearch in Google Scholar
  • 85 Benoist S, Panis Y, Beaufour A, Bouhnik Y, Matuchansky C, Valleur P. Laparoscopic ileocecal resection in Crohn's disease: a case-matched comparison with open resection. Surg Endosc 2003; 17 (05) 814-818
    CrossrefPubMedSearch in Google Scholar
  • 86 Evans J, Poritz L, MacRae H. Influence of experience on laparoscopic ileocolic resection for Crohn's disease. Dis Colon Rectum 2002; 45 (12) 1595-1600
    CrossrefPubMedSearch in Google Scholar
  • 87 Watanabe M, Ohgami M, Teramoto T, Hibi T, Kitajima M. Laparoscopic ileocecal resection for Crohn's disease associated with intestinal stenosis and ileorectal fistula. Surg Today 1999; 29 (05) 446-448
    CrossrefPubMedSearch in Google Scholar
  • 88 Cima RR, Wolff BG. Reoperative Crohn's surgery: tricks of the trade. Clin Colon Rectal Surg 2007; 20 (04) 336-343
    Thieme ConnectPubMedSearch in Google Scholar
  • 89 Uchikoshi F, Ito T, Nezu R. , et al. Advantages of laparoscope-assisted surgery for recurrent Crohn's disease. Surg Endosc 2004; 18 (11) 1675-1679
    PubMedSearch in Google Scholar
  • 90 Hasegawa H, Watanabe M, Nishibori H, Okabayashi K, Hibi T, Kitajima M. Laparoscopic surgery for recurrent Crohn's disease. Br J Surg 2003; 90 (08) 970-973
    CrossrefPubMedSearch in Google Scholar
  • 91 Thaler K, Dinnewitzer A, Oberwalder M, Weiss EG, Nogueras JJ, Wexner SD. Assessment of long-term quality of life after laparoscopic and open surgery for Crohn's disease. Colorectal Dis 2005; 7 (04) 375-381
    CrossrefPubMedSearch in Google Scholar
  • 92 Duff S, Sagar PM, Rao M, Dolling S, Sprakes M, Hamlin PJ. Infliximab and surgical treatment of complex anal Crohn's disease. Colorectal Dis 2012; 14 (08) 972-976
    CrossrefPubMedSearch in Google Scholar
  • 93 Sandborn WJ, Fazio VW, Feagan BG, Hanauer SB. ; American Gastroenterological Association Clinical Practice Committee. AGA technical review on perianal Crohn's disease. Gastroenterology 2003; 125 (05) 1508-1530
    CrossrefPubMedSearch in Google Scholar
  • 94 Judge TA, Lichtenstein GR. Treatment of fistulizing Crohn's disease. Gastroenterol Clin North Am 2004; 33 (02) 421-454 , xi–xii
    CrossrefPubMedSearch in Google Scholar
  • 95 Regueiro M, Mardini H. Treatment of perianal fistulizing Crohn's disease with infliximab alone or as an adjunct to exam under anesthesia with seton placement. Inflamm Bowel Dis 2003; 9 (02) 98-103
    CrossrefPubMedSearch in Google Scholar
  • 96 Topstad DR, Panaccione R, Heine JA, Johnson DR, MacLean AR, Buie WD. Combined seton placement, infliximab infusion, and maintenance immunosuppressives improve healing rate in fistulizing anorectal Crohn's disease: a single center experience. Dis Colon Rectum 2003; 46 (05) 577-583
    CrossrefPubMedSearch in Google Scholar
  • 97 Poritz LS, Rowe WA, Koltun WA. Remicade does not abolish the need for surgery in fistulizing Crohn's disease. Dis Colon Rectum 2002; 45 (06) 771-775
    CrossrefPubMedSearch in Google Scholar
  • 98 Lawal TA, Frischer JS, Falcone RA, Chatoorgoon K, Denson LA, Levitt MA. The transanal approach with laparoscopy or laparotomy for the treatment of rectal strictures in Crohn's disease. J Laparoendosc Adv Surg Tech A 2010; 20 (09) 791-795
    CrossrefPubMedSearch in Google Scholar
  • 99 Galandiuk S, Kimberling J, Al-Mishlab TG, Stromberg AJ. Perianal Crohn disease: predictors of need for permanent diversion. Ann Surg 2005; 241 (05) 796-801 , discussion 801–802
    CrossrefPubMedSearch in Google Scholar
  • 100 Regueiro M, El-Hachem S, Kip KE. , et al. Postoperative infliximab is not associated with an increase in adverse events in Crohn's disease. Dig Dis Sci 2011; 56 (12) 3610-3615
    CrossrefPubMedSearch in Google Scholar
  • 101 Bordeianou L, Stein SL, Ho VP. , et al. Immediate versus tailored prophylaxis to prevent symptomatic recurrences after surgery for ileocecal Crohn's disease?. Surgery 2011; 149 (01) 72-78
    CrossrefPubMedSearch in Google Scholar
  • 102 Spinelli A, Sacchi M, Fiorino G, Danese S, Montorsi M. Risk of postoperative recurrence and postoperative management of Crohn's disease. World J Gastroenterol 2011; 17 (27) 3213-3219 Review
    PubMedSearch in Google Scholar
  • 103 Schwartz DA, Maltz BE. Treatment of fistulizing inflammatory bowel disease. Gastroenterol Clin North Am 2009; 38 (04) 595-610 Review
    CrossrefPubMedSearch in Google Scholar
  • 104 Rutgeerts P. Review article: recurrence of Crohn's disease after surgery - the need for treatment of new lesions. Aliment Pharmacol Ther 2006; 24 (Suppl. 03) 29-32
    CrossrefPubMedSearch in Google Scholar
  • 105 Yoshida K, Fukunaga K, Ikeuchi H. , et al. Scheduled infliximab monotherapy to prevent recurrence of Crohn's disease following ileocolic or ileal resection: a 3-year prospective randomized open trial. Inflamm Bowel Dis 2012; 18 (09) 1617-1623
    CrossrefPubMedSearch in Google Scholar
  • 106 Lémann M. Review article: can post-operative recurrence in Crohn's disease be prevented?. Aliment Pharmacol Ther 2006; 24 (Suppl. 03) 22-28
    CrossrefPubMedSearch in Google Scholar
  • 107 Sandborn WJ, Feagan BG. The efficacy of azathioprine and 6-mercaptopurine for the prevention of postoperative recurrence in patients with Crohn's disease remains uncertain. Gastroenterology 2004; 127 (03) 990-993
    CrossrefPubMedSearch in Google Scholar
  • 108 Rutgeerts P. Strategies in the prevention of post-operative recurrence in Crohn's disease. Best Pract Res Clin Gastroenterol 2003; 17 (01) 63-73
    CrossrefPubMedSearch in Google Scholar
  • 109 Pelletier AL, Stefanescu C, Vincent C, Etienney I, Mentré F, Soulé JC. Is the length of postoperative recurrence on the neo ileum terminal ileum predictable in Crohn's disease?. J Crohn's Colitis 2011; 5 (01) 24-27
    PubMedSearch in Google Scholar
  • 110 Nissan A, Zamir O, Spira RM. , et al. A more liberal approach to the surgical treatment of Crohn's disease. Am J Surg 1997; 174 (03) 339-341
    CrossrefPubMedSearch in Google Scholar
  • 111 Blackburn SC, Wiskin AE, Barnes C. , et al. Surgery for children with Crohn's disease: indications, complications and outcome. Arch Dis Child 2014; 99 (05) 420-426
    CrossrefPubMedSearch in Google Scholar