医学
英夫利昔单抗
钙蛋白酶
克罗恩病
围手术期
胶囊内镜
外科
结肠镜检查
粪便潜血
疾病
内科学
胃肠病学
炎症性肠病
结直肠癌
癌症
作者
Çharles N. Bernstein,Miguel Regueiro
标识
DOI:10.1097/mcg.0000000000001865
摘要
Although surgery rates in Crohn's disease are declining in the past twenty years, bowel resection remains an important and still commonly used therapeutic option in Crohn's disease. Preoperatively, patients clinical status must be optimized including preparation for perioperative recovery including with nutrition optimization and preparation for postoperative pharmacotherapy. Postoperatively a medical therapy is often required and in recent years it has often been a biological therapy. One randomized controlled study suggested that infliximab is more likely to prevent endoscopic recurrence than placebo. But other biologicals have been used as well. Ileocolonoscopy should be undertaken by 6 months after an ileal or ileocecal resection especially. Adjunctive imaging such as transabdominal ultrasound, capsule endoscopy or cross sectional imaging may be required. Biomarker measurement with fecal calprotectin especially, or C-reactive protein, serum ferritin, serum albumin and serum hemoglobin will also be helpful.
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