Adv Surg. 2024 Sep;58(1):19-34. doi: 10.1016/j.yasu.2024.04.002.Epub 2024 May 16.

Dylan Carroll ¹, Sandy Kavalukas ²

Author information

¹Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY 40292, USA.

²Colorectal Surgery, Department of Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY 40292, USA. Electronic address: sandy.kavalukas@louisville.edu.

Abstract

Complications of Crohn's disease reach far beyond postsurgical leak, infection, and enterocutaneous fistula. Malnutrition, intestinal failure, and recurrent disease all will require ongoing attentions. The management of these patients may further be complicated by the need for chronic immunosuppression. The underlying principles continue to include optimization of nutritional status, and preservation of bowel length when possible. However, there have been several recent advances in both the medical and surgical management of the disease. Understanding the contribution of the mesentery to inflammation, new surgical techniques such as the Kono-S anastomosis and extended mesenteric resection is decreasing the need for repeated resections.