胃と腸45巻10号

2010年09月発行

今月の主題 Crohn病小腸病変に対する診断と治療の進歩

主題

Crohn病小腸病変に対する治療効果―狭窄形成術の進歩

著者： 河野透¹

所属機関： ¹旭川医科大学外科学講座消化器病態外科学分野

ページ範囲：P.1676 - P.1681

文献概要

要旨　外科的治療が対象となる小腸狭窄病変長が12cm以下であれば，Heineke-Mikulicz法やFinney法など，古典的な狭窄形成術は腸管切除より優先される外科的治療であり，古典的な狭窄形成術の短期，長期成績は良好である．しかし，大腸の狭窄形成術の有効性は明らかでない．適応外は狭窄病変部に膿瘍・瘻孔形成，内科的治療抵抗性の出血，瘻孔合併がある場合である．古典的な狭窄形成術が困難な症例にも，新たな狭窄形成術が開発されている．狭窄形成術では病変が残存するため，発癌の報告もあり，サーベイランスが重要となる．

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