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Surgical Management of Crohn’s Disease and Ulcerative Colitis

  • Robert R. CimaEmail author
  • John H. Pemberton
Chapter

Abstract

Crohn’s disease and chronic ulcerative colitis represent two ends of the spectrum of inflammatory bowel diseases. Many authors believe there is a complex interaction between genetics, environmental, dietary, and infectious agents that contribute to the onset and progression of both Crohn’s disease and chronic ulcerative colitis. Because the diseases affect the gut differently and in different places, surgical approaches are distinctly different between them. While in general, the surgical approach to patients with Crohn’s disease is one of conservation, the approach to patients with ulcerative colitis is extirpation of the colon with, in most patients, construction of a pelvic pouch, which facilitates defecation using the normal anatomic pathway. Operations for CD and CUC lend themselves to minimal access surgical techniques. The complications inherent in surgery for inflammatory bowel disease are numerous and need to be understood when discussing the goal of surgery for both diseases. The use of anti-TNF biologic therapy has been a great boon to the management of patients with CD, but in patients with ulcerative colitis, its use may complicate definitive surgical management (IPAA). While our understanding of the etiology and medical treatment of both diseases is improving, there is a large and defined role for surgery in the long-term management of patients with both CD and CUC.

Keywords

Crohn’s disease Chronic ulcerative colitis Surgery IPAA Biologic therapy 

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Division of Colon and Rectal SurgeryMayo Clinic College of MedicineRochesterUSA

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