Surgical Management of Crohn’s Disease

  • Daniel von Allmen


Inflammatory Bowel Disease Bowel Resection Short Bowel Syndrome Primary Anastomosis Subtotal Colectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Rabbett H, Elbadri A, Thwaites R, et al. Quality of life in children with Crohn’s disease. J Pediatr Gastroenterol Nutr. 1996 Dec;23(5):528–33.CrossRefGoogle Scholar
  2. 2.
    Hancock L, Windsor AC, Mortensen NJ. Inflammatory bowel disease: the view of the surgeon. Colorectal Dis. 2006 May;8 Suppl 1:10–4.CrossRefGoogle Scholar
  3. 3.
    Schraut WH. The surgical management of Crohn’s disease. Gastroenterol Clin North Am. 2002 Mar;31(1):255–63.CrossRefGoogle Scholar
  4. 4.
    Poggioli G, Pierangeli F, Laureti S, Ugolini F. Review article: indication and type of surgery in Crohn’s disease. Aliment Pharmacol Ther. 2002 Jul;16 Suppl 4:59–64.CrossRefGoogle Scholar
  5. 5.
    Leowardi C, Heuschen G, Kienle P, et al. Surgical treatment of severe inflammatory bowel diseases. Dig Dis. 2003;21(1):54–62.PubMedCrossRefGoogle Scholar
  6. 6.
    Aufses AH, Jr. The history of Crohn’s disease. Surg Clin North Am. 2001 Feb;81(1):1–11, vii.Google Scholar
  7. 7.
    Garlock JH, Crohn’s BB. Appraisal of results of surgery in the treatment of regional enteritis. J Am Med Assoc. 1945;127:205–8.Google Scholar
  8. 8.
    Greenstein AJ Sachar D, Pucillo A, et al. Cancer in Crohn’s disease after divisionary surgery. A report of seven carcinomas occurring in excluded bowel. Am J Surg. 1978;135:86–90.CrossRefGoogle Scholar
  9. 9.
    Dziki A, Galbfach P. Crohn’s disease–when to operate? Acta Chir Iugosl. 2004;51(2):61–8.PubMedCrossRefGoogle Scholar
  10. 10.
    McLeod RS. Surgery for inflammatory bowel diseases. Dig Dis. 2003;21(2):168–79.PubMedCrossRefGoogle Scholar
  11. 11.
    Veroux M, Angriman I, Ruffolo C, et al. Severe gastrointestinal bleeding in Crohn’s disease. Ann Ital Chir. 2003 Mar–Apr;74(2):213–5; discussion 6.Google Scholar
  12. 12.
    Andersson P, Olaison G, Bodemar G, et al. Surgery for Crohn’s colitis over a twenty-eight-year period: fewer stomas and the replacement of total colectomy by segmental resection. Scand J Gastroenterol. 2002 Jan;37(1):68–73.CrossRefGoogle Scholar
  13. 13.
    Hurst RD, Molinari M, Chung TP, et al. Prospective study of the features, indications, and surgical treatment in 513 consecutive patients affected by Crohn’s disease. Surgery. 1997 Oct;122(4):661–7;discussion 7–8.CrossRefGoogle Scholar
  14. 14.
    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 Nov;242(5):693–700.CrossRefGoogle Scholar
  15. 15.
    Rufo PA, Bousvaros A. Current Therapy of Inflammatory Bowel Disease in Children. Paediatr Drugs. 2006;8(5):279–302.PubMedCrossRefGoogle Scholar
  16. 16.
    Patel HI, Leichtner AM, Colodny AH, Shamberger RC. Surgery for Crohn’s disease in infants and children. J Pediatr Surg. 1997 Jul;32(7):1063–7; discussion 7–8.CrossRefGoogle Scholar
  17. 17.
    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 Jun;12(3):180–5.CrossRefGoogle Scholar
  18. 18.
    Konno M, Kobayashi A, Tomomasa T, et al. Guidelines for the treatment of Crohn’s disease in children. Pediatr Int. 2006 Jun;48(3):349–52.CrossRefGoogle Scholar
  19. 19.
    Nissan A, Zamir O, Spira RM, et al. A more liberal approach to the surgical treatment of Crohn’s disease. Am J Surg. 1997 Sep;174(3):339–41.CrossRefGoogle Scholar
  20. 20.
    Berg DF, Bahadursingh AM, Kaminski DL, Longo WE. Acute surgical emergencies in inflammatory bowel disease. Am J Surg. 2002 Jul;184(1):45–51.CrossRefGoogle Scholar
  21. 21.
    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 Apr;16(2):76–80.CrossRefGoogle Scholar
  22. 22.
    Froehlich F, Juillerat P, Mottet C, et al. Obstructive fibrostenotic Crohn’s disease. Digestion. 2005;71(1):29–30.PubMedCrossRefGoogle Scholar
  23. 23.
    Karaoglu AO, Yukselen V. Obstructing Crohn’s disease of the duodenum: is surgery always mandatory? Int J Clin Pract. 2004 Feb;58(2):221–3.CrossRefGoogle Scholar
  24. 24.
    Heimann TM, Greenstein AJ, Lewis B, et al. Comparison of primary and reoperative surgery in patients with Crohn’s disease. Ann Surg. 1998 Apr;227(4):492–5.CrossRefGoogle Scholar
  25. 25.
    Solem CA, Loftus EV, Jr., Tremaine WJ, et al. Fistulas to the urinary system in Crohn’s disease: clinical features and outcomes. Am J Gastroenterol. 2002 Sep;97(9):2300–5.CrossRefGoogle Scholar
  26. 26.
    Present DH. Urinary tract fistulas in Crohn’s disease: surgery versus medical therapy. Am J Gastroenterol. 2002 Sep;97(9):2165–7.CrossRefGoogle Scholar
  27. 27.
    Gruner JS, Sehon JK, Johnson LW. Diagnosis and management of enterovesical fistulas in patients with Crohn’s disease. Am Surg. 2002 Aug;68(8):714–9.Google Scholar
  28. 28.
    Ben-Ami H, Ginesin Y, Behar DM, et al. Diagnosis and treatment of urinary tract complications in Crohn’s disease: an experience over 15 years. Can J Gastroenterol. 2002 Apr;16(4):225–9.Google Scholar
  29. 29.
    Akobeng AK, Suresh-Babu MV, Firth D, et al. Quality of life in children with Crohn’s disease: a pilot study. J Pediatr Gastroenterol Nutr. 1999 Apr;28(4):S37–9.CrossRefGoogle Scholar
  30. 30.
    Glehen O, Lifante JC, Vignal J, et al. Small bowel length in Crohn’s disease. Int J Colorectal Dis. 2003 Sep;18(5):423–7.CrossRefGoogle Scholar
  31. 31.
    Yamamoto T, Bain IM, Mylonakis E, et al. Stapled functional end-to-end anastomosis versus sutured end-to-end anastomosis after ileocolonic resection in Crohn’s disease. Scand J Gastroenterol. 1999 Jul;34(7):708–13.CrossRefGoogle Scholar
  32. 32.
    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(5):493–6.PubMedCrossRefGoogle Scholar
  33. 33.
    Tersigni R, Alessandroni L, Barreca M, et al. Does stapled functional end-to-end anastomosis affect recurrence of Crohn’s disease after ileocolonic resection? Hepatogastroenterology. 2003 Sep–Oct;50(53):1422–5.Google Scholar
  34. 34.
    Yamamoto T. Factors affecting recurrence after surgery for Crohn’s disease. World J Gastroenterol. 2005 Jul 14;11(26):3971–9.Google Scholar
  35. 35.
    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 Mar;48(3):464–8.CrossRefGoogle Scholar
  36. 36.
    Larson DW, Pemberton JH. Current concepts and controversies in surgery for IBD. Gastroenterology. 2004 May;126(6):1611–9.Google Scholar
  37. 37.
    Munoz-Juarez 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 Jan;44(1):20–5;discussion 5–6.CrossRefGoogle Scholar
  38. 38.
    Yamamoto T, Allan RN, Keighley MR. Strategy for surgical management of ileocolonic anastomotic recurrence in Crohn’s disease. World J Surg. 1999 Oct;23(10):1055–60; discussion 60–1.CrossRefGoogle Scholar
  39. 39.
    Scarpa M, Angriman I, Barollo M, et al. Role of stapled and hand-sewn anastomoses in recurrence of Crohn’s disease. Hepatogastroenterology. 2004 Jul–Aug;51(58):1053–7.Google Scholar
  40. 40.
    Smedh K, Andersson M, Johansson H, Hagberg T. Preoperative management is more important than choice of sutured or stapled anastomosis in Crohn’s disease. Eur J Surg. 2002;168(3):154–7.PubMedCrossRefGoogle Scholar
  41. 41.
    Yamamoto T, Keighley MR. Stapled functional end-to-end anastomosis in Crohn’s disease. Surg Today. 1999;29(7):679–81.PubMedCrossRefGoogle Scholar
  42. 42.
    Galandiuk S. Stapled and hand-sewn anastomoses in Crohn’s disease. Dig Surg. 1998;15(6):655.PubMedCrossRefGoogle Scholar
  43. 43.
    Hashemi M, Novell JR, Lewis AA. Side-to-side stapled anastomosis may delay recurrence in Crohn’s disease. Dis Colon Rectum. 1998 Oct;41(10):1293–6.CrossRefGoogle Scholar
  44. 44.
    Colombel JF, Loftus EV, Jr., 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 May;99(5):878–83.CrossRefGoogle Scholar
  45. 45.
    Dietz DW, Fazio VW, Laureti S, et al. Strictureplasty in diffuse Crohn’s jejunoileitis: safe and durable. Dis Colon Rectum. 2002 Jun;45(6):764–70.CrossRefGoogle Scholar
  46. 46.
    Laurent S, Detry O, Detroz B, et al. Strictureplasty in Crohn’s disease: short- and long-term follow-up. Acta Chir Belg. 2002 Aug;102(4):253–5.Google Scholar
  47. 47.
    Hurst RD, Michelassi F. Strictureplasty for Crohn’s disease: techniques and long-term results. World J Surg. 1998 Apr;22(4):359–63.CrossRefGoogle Scholar
  48. 48.
    Poggioli G, Laureti S, Pierangeli F, Ugolini F. A new model of strictureplasty for multiple and long stenoses in Crohn’s ileitis: side-to-side diseased to disease-free anastomosis. Dis Colon Rectum. 2003 Jan;46(1):127–30.CrossRefGoogle Scholar
  49. 49.
    Shatari T, Clark MA, Yamamoto T, et al. Long strictureplasty is as safe and effective as short strictureplasty in small-bowel Crohn’s disease. Colorectal Dis. 2004 Nov;6(6):438–41.CrossRefGoogle Scholar
  50. 50.
    Sampietro GM, Cristaldi M, Maconi G, et al. A prospective, longitudinal study of nonconventional strictureplasty in Crohn’s disease. J Am Coll Surg. 2004 Jul;199(1):8–20;discussion -2.CrossRefGoogle Scholar
  51. 51.
    Michelassi F, Upadhyay GA. Side-to-side isoperistaltic strictureplasty in the treatment of extensive Crohn’s disease. J Surg Res. 2004 Mar;117(1):71–8.CrossRefGoogle Scholar
  52. 52.
    Tonelli F, Fedi M, Paroli GM, Fazi M. Indications and results of side-to-side isoperistaltic strictureplasty in Crohn’s disease. Dis Colon Rectum. 2004 Apr;47(4):494–501.CrossRefGoogle Scholar
  53. 53.
    Eisenberger CF, Izbicki JR, Broering DC, et al. Strictureplasty with a pedunculated jejunal patch in Crohn’s disease of the duodenum. Am J Gastroenterol. 1998 Feb;93(2):267–9.CrossRefGoogle Scholar
  54. 54.
    Milsom JW, Hammerhofer KA, Bohm B, et al. Prospective, randomized trial comparing laparoscopic vs. conventional surgery for refractory ileocolic Crohn’s disease. Dis Colon Rectum. 2001 Jan;44(1):1–8; discussion -9.CrossRefGoogle Scholar
  55. 55.
    Dutta S, Rothenberg SS, Chang J, Bealer J. Total intracorporeal laparoscopic resection of Crohn’s disease. J Pediatr Surg. 2003 May;38(5):717–9.CrossRefGoogle Scholar
  56. 56.
    Tilney HS, Constantinides VA, Heriot AG, et al. Comparison of laparoscopic and open ileocecal resection for Crohn’s disease: a metaanalysis. Surg Endosc. 2006 Jul;20(7):1036–44.CrossRefGoogle Scholar
  57. 57.
    Bonnard A, Fouquet V, Berrebi D, et al. Crohn’s disease in children. Preliminary experience with a laparoscopic approach. Eur J Pediatr Surg. 2006 Apr;16(2):90–3.CrossRefGoogle Scholar
  58. 58.
    Maartense S, Dunker MS, Slors JF, et al. Laparoscopic-assisted versus open ileocolic resection for Crohn’s disease: a randomized trial. Ann Surg. 2006 Feb;243(2):143–9; discussion 50–3.CrossRefGoogle Scholar
  59. 59.
    Casillas S, Delaney CP. Laparoscopic surgery for inflammatory bowel disease. Dig Surg. 2005;22(3):135–42.PubMedCrossRefGoogle Scholar
  60. 60.
    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 May–Jun;52(63):823–5.Google Scholar
  61. 61.
    Huilgol RL, Wright CM, Solomon MJ. Laparoscopic versus open ileocolic resection for Crohn’s disease. J Laparoendosc Adv Surg Tech A. 2004 Apr;14(2):61–5.CrossRefGoogle Scholar
  62. 62.
    von Allmen D, Markowitz JE, York A, et al. Laparoscopic-assisted bowel resection offers advantages over open surgery for treatment of segmental Crohn’s disease in children. J Pediatr Surg. 2003 Jun;38(6):963–5.CrossRefGoogle Scholar
  63. 63.
    Shore G, Gonzalez QH, Bondora A, Vickers SM. Laparoscopic vs conventional ileocolectomy for primary Crohn’s disease. Arch Surg. 2003 Jan;138(1):76–9.CrossRefGoogle Scholar
  64. 64.
    Wu JS, Birnbaum EH, Kodner IJ, et al. Laparoscopic-assisted ileocolic resections in patients with Crohn’s disease: are abscesses, phlegmons, or recurrent disease contraindications? Surgery. 1997 Oct;122(4):682–8;discussion 8–9.CrossRefGoogle Scholar
  65. 65.
    Milsom JW. Laparoscopic surgery in the treatment of Crohn’s disease. Surg Clin North Am. 2005 Feb;85(1):25–34;vii.Google Scholar
  66. 66.
    Seymour NE, Kavic SM. Laparoscopic management of complex Crohn’s disease. Jsls. 2003 Apr–Jun;7(2):117–21.Google Scholar
  67. 67.
    Benoist S, Panis Y, Beaufour A, et al. Laparoscopic ileocecal resection in Crohn’s disease: a case-matched comparison with open resection. Surg Endosc. 2003 May;17(5):814–8.CrossRefGoogle Scholar
  68. 68.
    Evans J, Poritz L, MacRae H. Influence of experience on laparoscopic ileocolic resection for Crohn’s disease. Dis Colon Rectum. 2002 Dec;45(12):1595–600.CrossRefGoogle Scholar
  69. 69.
    Watanabe M, Ohgami M, Teramoto T, et al. Laparoscopic ileocecal resection for Crohn’s disease associated with intestinal stenosis and ileorectal fistula. Surg Today. 1999;29(5):446–8.PubMedCrossRefGoogle Scholar
  70. 70.
    Uchikoshi F, Ito T, Nezu R, et al. Advantages of laparoscope-assisted surgery for recurrent Crohn’s disease. Surg Endosc. 2004 Nov;18(11):1675–9.Google Scholar
  71. 71.
    Hasegawa H, Watanabe M, Nishibori H, et al. Laparoscopic surgery for recurrent Crohn’s disease. Br J Surg. 2003 Aug;90(8):970–3.CrossRefGoogle Scholar
  72. 72.
    Thaler K, Dinnewitzer A, Oberwalder M, et al. Assessment of long-term quality of life after laparoscopic and open surgery for Crohn’s disease. Colorectal Dis. 2005 Jul;7(4):375–81.CrossRefGoogle Scholar
  73. 73.
    Andersson P, Olaison G, Hallbook O, Sjodahl R. Segmental resection or subtotal colectomy in Crohn’s colitis? Dis Colon Rectum. 2002 Jan;45(1):47–53.CrossRefGoogle Scholar
  74. 74.
    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 Apr;194(4):448–53.CrossRefGoogle Scholar
  75. 75.
    Bernell O, Lapidus A, Hellers G. Recurrence after colectomy in Crohn’s colitis. Dis Colon Rectum. 2001 May;44(5):647–54;discussion 54.CrossRefGoogle Scholar
  76. 76.
    Fichera A, McCormack R, Rubin MA, et al. Long-term outcome of surgically treated Crohn’s colitis: a prospective study. Dis Colon Rectum. 2005 May;48(5):963–9.CrossRefGoogle Scholar
  77. 77.
    Rieger N, Collopy B, Fink R, et al. Total colectomy for Crohn’s disease. Aust N Z J Surg. 1999 Jan;69(1):28–30.CrossRefGoogle Scholar
  78. 78.
    Proctor ML, Langer JC, Gerstle JT, Kim PC. Is laparoscopic subtotal colectomy better than open subtotal colectomy in children? J Pediatr Surg. 2002 May;37(5):706–8.CrossRefGoogle Scholar
  79. 79.
    Sandborn WJ, Fazio VW, Feagan BG, Hanauer SB. AGA technical review on perianal Crohn’s disease. Gastroenterology. 2003 Nov;125(5):1508–30.CrossRefGoogle Scholar
  80. 80.
    Judge TA, Lichtenstein GR. Treatment of fistulizing Crohn’s disease. Gastroenterol Clin North Am. 2004 Jun;33(2):421–54, xi-xii.Google Scholar
  81. 81.
    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 Mar;9(2):98–103.CrossRefGoogle Scholar
  82. 82.
    Topstad DR, Panaccione R, Heine JA, et al. 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 May;46(5):577–83.CrossRefGoogle Scholar
  83. 83.
    Poritz LS, Rowe WA, Koltun WA. Remicade does not abolish the need for surgery in fistulizing Crohn’s disease. Dis Colon Rectum. 2002 Jun;45(6):771–5.CrossRefGoogle Scholar
  84. 84.
    Galandiuk S, Kimberling J, Al-Mishlab TG, Stromberg AJ. Perianal Crohn’s disease: predictors of need for permanent diversion. Ann Surg. 2005 May;241(5):796–801; discussion -2.CrossRefGoogle Scholar
  85. 85.
    Rintala RJ, Lindahl HG. Proctocolectomy and J-pouch ileo-anal anastomosis in children. J Pediatr Surg. 2002 Jan;37(1):66–70.CrossRefGoogle Scholar
  86. 86.
    Su FW, Beckman DB, Yarnold PA, Grammer LC. Low incidence of complications in asthmatic patients treated with preoperative corticosteroids. Allergy Asthma Proc. 2004 Sep–Oct;25(5):327–33.Google Scholar
  87. 87.
    Marchal L, D’Haens G, Van Assche G, et al. The risk of post-operative complications associated with infliximab therapy for Crohn’s disease: a controlled cohort study. Aliment Pharmacol Ther. 2004 Apr 1;19(7):749–54.CrossRefGoogle Scholar
  88. 88.
    Rutgeerts P. Review article: recurrence of Crohn’s disease after surgery - the need for treatment of new lesions. Aliment Pharmacol Ther. 2006 Oct;24 Suppl 3:29–32.CrossRefGoogle Scholar
  89. 89.
    Sorrentino D, Terrosu G, Avellini C, et al. Prevention of postoperative recurrence of Crohn’s disease by infliximab. Eur J Gastroenterol Hepatol. 2006 Apr;18(4):457–9.CrossRefGoogle Scholar
  90. 90.
    Lemann M. Review article: can post-operative recurrence in Crohn’s disease be prevented? Aliment Pharmacol Ther. 2006 Oct;24 Suppl 3:22–8.CrossRefGoogle Scholar
  91. 91.
    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 Sep;127(3):990–3.CrossRefGoogle Scholar
  92. 92.
    Rutgeerts P. Strategies in the prevention of post-operative recurrence in Crohn’s disease. Best Pract Res Clin Gastroenterol. 2003 Feb;17(1):63–73.CrossRefGoogle Scholar
  93. 93.
    Stephens M, Batres LA, Ng D, Baldassano R. Growth failure in the child with inflammatory bowel disease. Semin Gastrointest Dis. 2001 Oct;12(4):253–62.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Daniel von Allmen
    • 1
  1. 1.Division of Pediatric SurgeryThe University of North Carolina Chapel HillChapel HillUSA

Personalised recommendations