李毅医生的科普号

李毅医生团队的研究发现，对于需要手术的克罗恩病患者，切除病变肠系膜能够降低克罗恩病术后复发，改善长期预后。请扫描下面的二维码观看。

近日，南京大学医学院附属金陵医院李毅教授与爱尔兰利莫瑞克大学JohnCalvinCoffey教授（肠系膜器官提出者）在国际外科学知名期刊Surgery联合发文，阐述旨在降低克罗恩病术后疾病再发、改善克罗恩病远期预后的外科术式“基于肠系膜的手术策略”。本文对当前的手术策略进行了阐述，重点叙述了肠系膜在克罗恩病的病理生理改变和机制、在术后疾病再发中的可能作用及其在手术策略中的当前研究现状，并对此做以展望。全文链接：https://mp.weixin.qq.com/s/xvJpgNJoYrCiQ913Q1_Gug

克罗恩病"Crohn's disease, CD" 自1923年以克罗恩医生命名，此后，从事基础医学的科学家、生物学家及临床医生从未停止对其发病原因、诊断方法、治疗手段的不懈追求与探索，历经数十载的努力，尽管在克罗恩病的病因、诊断、治疗方面取得和很大的进展，克罗恩病至今仍属于病因未知、无诊断金标准、治疗手段匮乏、预后不佳的良性疾病，这也是其时至今日仍以人名命名被称呼为“克罗恩病”的原因，而不同于“肠结核”这一已获明确病因诊断的疾病，尽管两者症状在一些方面相似。国际著名期刊Lancet发表社论，期望在克罗恩病命名百年之际，在基础及临床医学的不懈努力下，最终攻克并治愈克罗恩病（A cure for Crohn’s disease by 2032; Lancet 2016; 388: 1281–1290）。Since 1932, when Burrill Crohn, Leon Ginzburg, and Gordon Oppenheimer codifi ed regional ileitis as a distinct clinical and pathological entity, successive approaches to care have been unable to achieve universal success against the relapsing nature of the illness. Research is not keeping up with need. Each year Crohn’s disease snatchesthe quality out of life for an increasing number of young adults, in more and more countries. Findings from FITZROY add to the rapidly accumulating knowledge of genetic, environmental, microbiota, molecular, and immune factors involved in infl ammatory bowel disease. They should serve to bolster and accelerate recent momentum in research about Crohn’s disease and the translation of new insights into opportunities for prevention and earlier intervention.What better way to mark the centenary of Crohn’s description in 15 years’ time than by off ering new hope to the next generation of people with the disease? Doing so requires more reliable biomarkers that correlate better with endoscopic fi ndings and prognosis, improved understanding of individual responsiveness, bolder attitudes about treatments, their goals and timing, and more emphasis on care in resource-limited settings. Alternative mechanisms, such as repair of disordered signalling pathways and the microbiome, should also be considered. In the countdown to 2032, real progress can be made with concerted, collaborative eff ort; particularly if researchers and funders aspire beyond the target of deep remission to the possibility of cure.  The Lancet

李毅教授：克罗恩病肠道狭窄治疗新策略，腹腔镜与内镜双镜联合处理克罗恩病肠道狭窄。

炎症性肠病外科治疗中国专家共识意见。

炎症性肠病的饮食管理参考。

直肠瘘管型克罗恩病主要包括小肠直肠瘘、直肠膀胱瘘和直肠阴道瘘，具有手术操作复杂和终身性造口风险大等特点，是克罗恩病治疗中的巨大挑战。

狭窄成形术是适用于克罗恩病肠狭窄患者的一种手术方式，在不切除肠管的情况下解决肠道狭窄、解除患者的肠梗阻，尽可能保留患者的肠管长度，从而避免短肠综合征的发生。