New Advances in Surgical Treatment of Crohn ’ s Disease

35 INTRODUCTION C rohn’s disease is a chronic inflammatory disease of the gastrointestinal tract first described by Crohn, Ginzberg and Oppenheimer in 1932. Incidence of the disease is estimated at eight per 100,0000 with a prevalence of 170 per 100,000 (1). Transmural inflammation and lymphoid aggregates differentiate Crohn’s disease from ulcerative colitis and may occur in contiguous or classic “skip” lesions anywhere from the mouth to the anus. Although medical management may improve or even remit symptoms of Crohn’s disease, there is no cure for the disease. Complications including strictures, abscess, fistulas, perforation, hemorrhage, toxic dilation, and malignancy can occur and necessitate surgical treatment. Approximately 80% of patients diagnosed with Crohn’s disease require operative intervention at some point in their life (2). Of these patients 20%–70% will undergo a second surgical procedure in the course of their disease (3,4). Given the high rate of re-operative intervention and recurrent disease, recent advances in the surgical treatment of Crohn’s disease have focused on bowel sparing, minimizing invasiveness, and improving New Advances in Surgical Treatment of Crohn’s Disease INFLAMMATORY BOWEL DISEASE: A PRACTICAL APPROACH, SERIES #40