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Kirurgisk behandling af Crohns sygdom
Engelsk titel: Surgical treatment of Crohn disease Läs online Författare: Töttrup A ; Basu D Språk: Dan Antal referenser: 34 Dokumenttyp: Översikt UI-nummer: 04031546

Tidskrift

Ugeskrift for Laeger 2004;166(7)571-4 ISSN 0041-5782 E-ISSN 1603-6824 KIBs bestånd av denna tidskrift Denna tidskrift är expertgranskad (Peer-Reviewed)

Sammanfattning

Surgical intervention is necessary in many patients with Crohn's disease, with the main indications for surgery being various complications such as stricture or fistula formation; however, some patients are operated on because of unsatisfactory response to medical treatment. The decision about when to operate may be a difficult one, and it is particularly important that the patient does not lose weight and that the level of serum albumin does not decrease during the evaluation phase. It is recommended to limit the extent of bowel resection and to use strictureplasty in the treatment of strictures of the small bowel and ileocolic anastomoses. During the operation, it may be valuable to assess the extent of the disease by intraluminal methods. Approximately 50% of patients will experience a recurrence requiring a second operation within 15 years after the first procedure. Medical prophylaxis with either 5-ASA preparations or azathioprine should be considered, and patients should be informed that smoking increases the likelihood of recurrence.