The majority of patients with Crohn's disease and a proportion of patients with ulcerative colitis will ultimately require surgical treatment despite advances in diagnosis, therapy, and endoscopic interventions. The surgical procedures that are most commonly done include bowel resection with anastomosis, strictureplasty, faecal diversion, and ileal pouch. These surgical treatment modalities result in substantial alterations in bowel anatomy. In patients with inflammatory bowel disease, endoscopy plays a key role in the assessment of disease activity, disease recurrence, treatment response, dysplasia surveillance, and delivery of endoscopic therapy. Endoscopic evaluation and management of surgically altered bowel can be challenging. This consensus guideline delineates anatomical landmarks and endoscopic assessment of these landmarks in diseased and surgically altered bowel.
- MeSH
- Anastomosis, Surgical methods MeSH
- Anatomic Landmarks diagnostic imaging MeSH
- Digestive System Surgical Procedures adverse effects MeSH
- Crohn Disease diagnosis surgery MeSH
- Adult MeSH
- Endoscopy methods MeSH
- Inflammatory Bowel Diseases surgery MeSH
- Consensus MeSH
- Middle Aged MeSH
- Humans MeSH
- Colonic Pouches adverse effects MeSH
- Proctocolectomy, Restorative methods MeSH
- Recurrence MeSH
- Practice Guidelines as Topic MeSH
- Constriction, Pathologic surgery MeSH
- Intestines anatomy & histology pathology surgery MeSH
- Severity of Illness Index MeSH
- Colitis, Ulcerative diagnosis surgery MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- Research Support, N.I.H., Extramural MeSH
Stricture formation is a common complication of Crohn's disease, resulting from the disease process, surgery, or drugs. Endoscopic balloon dilation has an important role in the management of strictures, with emerging techniques, such as endoscopic electroincision and stenting, showing promising results. The underlying disease process, altered bowel anatomy from disease or surgery, and concurrent use of immunosuppressive drugs can make endoscopic procedures more challenging. There is an urgent need for the standardisation of endoscopic procedures and peri-procedural management strategies. On the basis of an extensive literature review and the clinical experience of the consensus group, which consisted of representatives from the Interventional Inflammatory Bowel Disease Group, we propose detailed guidance on all aspects of the principles and techniques for endoscopic procedures in the treatment of inflammatory bowel disease-associated strictures.
- MeSH
- Crohn Disease complications diagnostic imaging epidemiology pathology MeSH
- Dilatation instrumentation MeSH
- Endoscopy, Gastrointestinal methods MeSH
- Outcome Assessment, Health Care MeSH
- Inflammatory Bowel Diseases complications therapy MeSH
- Immunosuppressive Agents adverse effects MeSH
- Consensus MeSH
- Humans MeSH
- Disease-Free Survival MeSH
- Risk Factors MeSH
- Practice Guidelines as Topic MeSH
- Constriction, Pathologic etiology pathology therapy MeSH
- Stents adverse effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Research Support, N.I.H., Extramural MeSH
Interventional (or therapeutic) inflammatory bowel disease (IBD) endoscopy has an expanding role in the treatment of disease and surgical adverse events. Endoscopic therapy has been explored and used in the management of strictures, fistulas/abscesses, colitis-associated neoplasia, postsurgical acute or chronic leaks, and obstructions. The endoscopic therapeutic modalities include balloon dilation, stricturotomy, stent placement, fistulotomy, fistula injection and clipping, sinusotomy, EMR, and endoscopic submucosal dissection. With a better understanding of the disease course of IBD, improved long-term impact of medical therapy, and advances in endoscopic technology, we can foresee interventional IBD becoming an integrated part of the multidisciplinary approach to patients with complex IBD.
- MeSH
- Biological Products therapeutic use MeSH
- Abdominal Abscess etiology surgery MeSH
- Endoscopic Mucosal Resection MeSH
- Endoscopy, Gastrointestinal * MeSH
- Inflammatory Bowel Diseases complications drug therapy surgery MeSH
- Colorectal Neoplasms etiology surgery MeSH
- Humans MeSH
- Anastomotic Leak surgery MeSH
- Constriction, Pathologic MeSH
- Intestinal Obstruction etiology surgery MeSH
- Intestinal Fistula etiology surgery MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Gastroenterology clinics of North America, ISSN 0889-8553 vol. 35, no. 3, September 2006
xii, 517-734 s. : il., tab. ; 23 cm
- MeSH
- Digestive System Surgical Procedures MeSH
- Endoscopy, Digestive System MeSH
- Inflammatory Bowel Diseases MeSH
- Intestinal Neoplasms MeSH
- Colitis, Ulcerative complications epidemiology MeSH
- Publication type
- Collected Work MeSH
- Conspectus
- Patologie. Klinická medicína
- NML Fields
- gastroenterologie
- onkologie
