Surgical Management of Crohn's Disease - cme

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Anastomotic technique• Stapled versus handsewn• 7 trials, 1125 patients (441 stapled,684 handsewn)• Stapled anastomoses associated withsignificantly fewer leaks than handsewn• No difference in other outcomes(stricture, time, bleeding, reoperation,mortality, LOS, abscess, woundinfection)• Side to side versus end to end• Multicenter, RCT• 139 patients per group, 1 yr followup• No difference in endoscopic (40%) orsymptomatic (20%) recurrence rate
<strong>Surgical</strong> decision making• Timing <strong>of</strong> surgery• Preoperative infection control• Resection margins• Anastomotic technique• Strictureplasty versus resection• Laparoscopic versus open surgery• Segmental versus total colectomy• Perioperative CD medications
Page 3: PhenotypesInflammatory Stricturing
Page 6 and 7: Goals of surgical management• Pal
Page 8 and 9: Surgical decision making• Timing
Page 10: Perforating Crohn's ileitis: delay
Page 15 and 16: Intraabdominal abscessInfluence of
Page 18 and 19: Effect of resection margins on the
Page 22 and 23: Strictureplasty• First described
Page 24 and 25: Surgery for Crohn’s Disease: Stri
Page 32 and 33: Laparoscopic surgery• Cochrane Da
Page 34 and 35: Crohn’s colitis• Disease patter
Page 38 and 39: SteroidsTotal complicationsSeptic c
Page 40 and 41: Biologics
Page 42: Summary• Surgery for CD is pallia

Surgical Management of Crohn's Disease - cme

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