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Surgery in Crohn’s Disease: “Limited Versus Wide Resection”

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Inflammatory Bowel Diseases 1986

Part of the book series: Developments in Gastroenterology ((DIGA,volume 8))

Abstract

Fifty-three years have passed since Crohn’s disease was first recognized (1), fifty-three years in which the development of the surgical approach has given rise to much controversy, still continuing today, centred mainly on the type of operation to be undertaken. After bitter arguments between the supporters or bypass, first in continuity and then with exclusion, and the advocates of intestinal resection, we were convinced that this was the best course to pursue. The greater morbidity rate (2,3) and the increasingly evident inherent risks - closed loop, free perforation, cancer (4) - led to by-pass being reserved almost exclusively to duodenal stricture and particular cases of widespread or universal Crohn’s disease (5). Discussion then turned to “limited versus wide resection”,a subject not entirely resolved even now, though the pendulum swings more and more towards “limited”, and new, more conservative surgical approaches are gaining ground (5,6). Even though this article has kept the “classic” perhaps out-of-date title, it will focus not only on the reasons behind this tendency but also on the aim of surgery in Crohn’s disease and the intraoperative strategies necessary to achieve it. And it is mainly here that opinions differ.

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Authors and Affiliations

  1. VI Clinica Chirurgica, University of Rome “La Sapienza” Medical School, Rome, Italy

    V. Speranza, M. Simi & S. Leardi

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  1. V. Speranza
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  2. M. Simi
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  3. S. Leardi
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  1. Hadassah University Hospital, Jerusalem, Israel

    Daniel Rachmilewitz

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© 1986 Martinus Nijhoff Publishers

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Speranza, V., Simi, M., Leardi, S. (1986). Surgery in Crohn’s Disease: “Limited Versus Wide Resection”. In: Rachmilewitz, D. (eds) Inflammatory Bowel Diseases 1986. Developments in Gastroenterology, vol 8. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-4269-1_28

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  • DOI: https://doi.org/10.1007/978-94-009-4269-1_28

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-8396-6

  • Online ISBN: 978-94-009-4269-1

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