Perioperative optimization for Crohn's disease surgery / 肠外与肠内营养

ABSTRACT

Crohn's disease (CD) is a chronic idiopathic inflammatory bowel disease that can affect any part of the gastrointestinal tract. Major complications include formation of strictures, fistulas or abscesses. These complicating factors of CD pose significant challenges to the clinician. Despite significant advances in therapy over the past decades, a significant proportion of the patients will eventually require surgery, with at least one third of patients requiring multiple surgeries. The surgical treatment of CD focuses on the elimination of disease symptoms while solving the complications and maintaining intestinal continuity. Before surgery, patients may have experienced long-term course of disease, repeated treatment failure, malnutrition and side effects of medicine. Postoperative complications are seen more frequently in patients requiring abdominal surgery for CD than in patients requiring abdominal surgery for other conditions. Therefore, perioperative optimization strategy is critical to reduce the postoperative complications, to avoid future recurrence and to maintain surgery induced remission.