Quoi de neuf dans la prise en charge chirurgicale des maladies inflammatoires de l’intestin et de la diverticulite depuis la fin du dernier millénaire ?

What’s new in surgical management of inflammatory bowel disease and diverticulitis since year 2K?

Résumé

Des évolutions sont survenues entre 2000 et 2015 dans la prise en charge chirurgicale de la maladie de Crohn, de la rectocolite hémorragique et de la diverticulite sigmoïdienne. La laparoscopie est maintenant considérée comme la voie d’abord recommandée pour ces 3 pathologies, avec des avantages à court terme mais aussi pour la fertilité en cas de réalisation d’une anastomose iléo-anale dans la rectocolite hémorragique. Cette intervention n’est plus considérée par ailleurs comme une contre-indication dans la maladie de Crohn et peut se discuter dans des cas bien particuliers. Dans la diverticulite, des recommandations ont été publiées en 2006. Celles-ci restent encore d’actualité, notamment pour les indications de chirurgie prophylactique chez les patients jeunes et chez ceux ayant eu un épisode compliqué de diverticulite.

Abstract

Advances have been observed between 2000 and 2015 in the surgical management of Crohn’s disease, ulcerative colitis and diverticulitis. Laparoscopy is now considered as the recommended surgical approach for these three diseases, with short-term benefits but also with better fertility than after open surgery for ileal pouch anal anastomosis performed for ulcerative colitis. This intervention is no more considered as a definitive contradication in Crohn’s disease and can be discussed in selected cases. In diverticulitis, French guidelines were published in 2006. These still remain valid, especially for indications of prophylactic surgery in younger patients and in those who have had an episode of complicated diverticulitis.

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Correspondence to Y. Panis.

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Manceau, G., Panis, Y. Quoi de neuf dans la prise en charge chirurgicale des maladies inflammatoires de l’intestin et de la diverticulite depuis la fin du dernier millénaire ?. Colon Rectum 9, 30–35 (2015). https://doi.org/10.1007/s11725-015-0567-5

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Mots clés

  • Laparoscopie
  • Maladie de Crohn
  • Anastomose iléo-anale
  • Rectocolite hémorragique
  • Fertilité
  • Diverticulite

Keywords

  • Laparoscopy
  • Crohn’s disease
  • Ileal pouch anal anastomosis
  • Ulcerative colitis
  • Fertility
  • Diverticulitis