Thursday, April 15, 2010

Laparoscopic Resection for IBD

General Principles:
- Ensure that you review pathology to differentiate CD from UC

- Perianal disease is a red flag for CD. 
- however, may be coincidental, biopsies of local fistula may not differentiate
- increased perioperative morbidity in pts on Remicaide
- Safest approach would be to perform total colectomy to get better pathology and return to fight another day.


Chronic Crohn's Colitis:
- NEVER do a segmental resection
- Controversy regarding reconstruction, IRA can be considered in select patients with rectal sparing.  Pt must be informed that inevitable re-resection of rectum is likely.

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