Surgical Management of Intestinal Lesions in Crohn's Disease

Abstract

The principle of surgical management in Crohn's disease is conservative resection of the diseased intestine while retaining as much of the healthy segment as possible. Various types of stricture plasties are used for fibrous stricture, which enables the conservation of healthy intestine. Fecal diversion is indicated for cases of poor risk or with poor anorectal function. In western countries, an algorithm for the postoperative maintenance regimen has been proposed, in which 5-ASA is used in mild disease, immunomodulators are indicated for moderate disease, and infliximab is added for high risk or severe cases, with regular follow-up using endoscopy at 6- to 12-month intervals. In Japan, more careful management with a basic diet is expected to be practiced.