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Advances in the surgical management of inflammatory bowel disease

Nandivada, Prathima; Poylin, Vitaly; Nagle, Deborah

Current Opinion in Gastroenterology: January 2012 - Volume 28 - Issue 1 - p 47–51
doi: 10.1097/MOG.0b013e32834d8fcb
LARGE INTESTINE: Edited by Ciarán Kelly
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Purpose of review The principles of surgical management of inflammatory bowel disease (IBD) continue to evolve with advances in medical therapy, surgical technique, and minimally invasive operative technology. The purpose of this review is to highlight such advances in colorectal and anorectal surgery for IBD over the last year.

Recent findings Treatment of ulcerative colitis and Crohn's disease remains challenging and relies on knowledge of both medical and surgical therapies. Recent data support shorter hospitalization prior to surgical intervention in patients with acute severe ulcerative colitis, laparoscopic surgical approaches when feasible, and ciprofloxacin as optimal therapy for pouchitis, when preventive therapy with probiotics is not successful.

Summary The management of IBD remains complex and highly individualized. In severe cases, a combination of immunosuppression and surgical therapies may be required. However, the associated risks of complications make judgments about optimal treatment plans challenging.

Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

Correspondence to Deborah Nagle, MD, Chief, Colon and Rectal Surgery, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Stoneman 9, Suite 9, Boston, MA 02215, USA. Tel: +1 617 667 4170; e-mail: dnagle@bidmc.harvard.edu

© 2012 Lippincott Williams & Wilkins, Inc.