Our Summary

This paper discusses abdominal surgery for patients with Crohn’s disease, a condition that causes inflammation of the digestive tract. Despite many advanced treatments, most patients with Crohn’s disease will need abdominal surgery at some point in their lives. This paper covers different types of surgeries, such as those for upper gastrointestinal Crohn’s disease and bowel-preserving surgeries. It also talks about how to choose the right technique for certain kinds of surgeries, and goes into detail about more complex procedures. The discussion also touches on “hot topics” like early surgery for a specific type of Crohn’s disease, and surgical methods that focus on the mesentery, a fold of tissue that anchors the small intestines to the back of the abdominal wall.

FAQs

  1. What different surgical approaches are available for treating Crohn’s disease?
  2. How is the Kono-S anastomosis and extended mesenteric excision used in the treatment of Crohn’s disease?
  3. What is the role of ileocolic resection and ileostomy in the treatment of Crohn’s disease?

Doctor’s Tip

One helpful tip a doctor may give a patient about bowel resection is to follow a post-operative care plan that includes proper wound care, pain management, and dietary guidelines to aid in recovery and prevent complications. It is also important to attend follow-up appointments with your healthcare provider to monitor your progress and address any concerns. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support healing and overall well-being after bowel resection surgery.

Suitable For

Patients with Crohn’s disease who have complications such as strictures, fistulas, abscesses, perforations, or bleeding may be recommended for bowel resection. Additionally, patients who have not responded to medical therapy or who have recurrent or severe symptoms despite treatment may also be candidates for surgery. Other conditions that may require bowel resection include colorectal cancer, diverticulitis, ischemic bowel disease, and bowel obstructions. Ultimately, the decision to recommend bowel resection is based on the individual patient’s specific circumstances and the goals of treatment.

Timeline

Before bowel resection:

  • Patient is diagnosed with Crohn’s disease and undergoes various medical treatments such as medication therapy, dietary changes, and lifestyle modifications.
  • Despite medical treatment, the patient’s symptoms worsen and surgical intervention is deemed necessary.
  • Patient undergoes preoperative evaluations, including blood tests, imaging studies, and consultations with the surgical team.
  • Patient is admitted to the hospital and undergoes bowel resection surgery, which may involve removal of a portion of the intestine affected by Crohn’s disease.

After bowel resection:

  • Patient is closely monitored in the hospital for complications such as infection, bleeding, or blockage.
  • Patient may require a temporary ileostomy or colostomy to allow the bowel to heal.
  • Patient undergoes postoperative rehabilitation, including physical therapy and dietary counseling.
  • Patient is discharged from the hospital and continues to follow up with the surgical team for monitoring of Crohn’s disease and any potential complications from the surgery.
  • Patient may experience improvements in symptoms such as abdominal pain, diarrhea, and weight loss following the bowel resection.

What to Ask Your Doctor

  1. What is a bowel resection and why is it necessary for my Crohn’s disease?
  2. What are the potential risks and complications associated with bowel resection surgery?
  3. What is the recovery process like after bowel resection surgery?
  4. Will I need to make any lifestyle changes or follow a special diet after the surgery?
  5. How long will it take for me to fully recover and resume normal activities?
  6. Will I need to take any medication or undergo additional treatments after the surgery?
  7. Are there any long-term effects or complications I should be aware of after bowel resection surgery?
  8. What is the success rate of bowel resection surgery for Crohn’s disease?
  9. Are there any alternative treatment options to bowel resection that I should consider?
  10. How often will I need to follow up with you or a specialist after the surgery?

Reference

Authors: Khan I, Holubar SD. Journal: Surg Clin North Am. 2025 Apr;105(2):247-276. doi: 10.1016/j.suc.2024.09.006. Epub 2025 Jan 6. PMID: 40015815