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Application of a linear stapler to the laparoscopic treatment of gastrocolic fistula in patients with Crohn’s disease

  • S. Nagai
  • K. Nagayoshi
  • Y. Sadakari
  • H. Fujita
  • K. Ohuchida
  • T. Ohtsuka
  • M. Nakamura
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Introduction

Crohn’s disease (CD) is a chronic bowel disease characterized by inflammation of the gastrointestinal tract. All segments of the gastrointestinal tract can be affected, leading to complications such as strictures, abscesses, or fistulas. Although internal fistulas occur in approximately 20–35% of patients with CD, gastrocolic fistulas are very rare [1].

Despite improvement in medical therapy for patients with CD, such as treatment with steroids, azathioprine, and anti-tumor necrosis factor-α agents, patients with gastrocolic fistulas nearly always require surgical treatment. Minimally invasive surgery for inflammatory disease was recently shown to be safe and effective. We have also reported the feasibility of laparoscopic surgery for CD [2]. However, laparoscopic surgery for CD often results in conversion to open laparotomy. The conversion rate of laparoscopic surgery in patients with CD reportedly ranges from 8.5 to 13.4% [3]. One reason for conversion is the difficulty...

Notes

Acknowledgements

We thank Angela Morben, DVM, ELS, from Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

procedures performed in this study were in accordance with the ethical standards of the institution.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Sheen E, Huang RJ, Triadafilopoulos G (2013) Two evils: gastrocolic fistula and heart failure. Dig Dis Sci 59:928–932CrossRefPubMedGoogle Scholar
  2. 2.
    Manabe T, Ueki T, Nagayoshi K et al (2016) Feasibility of laparoscopic surgery for complex Crohn’s disease of the small intestine. Asian J Endosc Surg 9:265–269CrossRefPubMedCentralPubMedGoogle Scholar
  3. 3.
    Toh JW, Stewart P, Rickard MJ et al (2016) Indications and surgical options for small bowel, large bowel and perianal Crohn’s disease. WJG 22:8892–8814CrossRefPubMedGoogle Scholar
  4. 4.
    Watanabe W, Hasegawa H, Yamamoto S, Hibi T, Kitajima M (2002) Successful application of laparoscopic surgery to the treatment of Crohn’s disease with fistulas. Dis Colon Rectum 45:1057–1061CrossRefPubMedGoogle Scholar
  5. 5.
    Ballester-Pla N, Pous-Serrano S, Palasí-Giménez R, García-Granero E (2016) Use of a linear stapler for the treatment of ileocolic fistula in Crohn’s disease. Colorectal Dis 18:385–387CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • S. Nagai
    • 1
  • K. Nagayoshi
    • 1
  • Y. Sadakari
    • 1
  • H. Fujita
    • 1
  • K. Ohuchida
    • 1
  • T. Ohtsuka
    • 1
  • M. Nakamura
    • 1
  1. 1.Department of Surgery and Oncology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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