Maladie de Crohn postop´ératoire : Techniques de prise en charge actuelles et nouvelles
Résumé
Depuis l’approbation de l’infliximab en 1998, de nombreuses options thérapeutiques ont été proposées pour la maladie de Crohn (MC). Les traitements de la MC ont également évolué : la surveillance thérapeutique des médicaments et le traitement ciblé ont remplacé la maîtrise des symptômes. Malgré une diminution des taux d’interventions chirurgicales au Canada et ailleurs dans le monde, l’entérectomie est toujours nécessaire pour les patients atteints de MC réfractaire, fistulisante ou fibrosténosante. Malheureusement, la récidive postopératoire (RPO) est fréquente; la récidive endoscopique touche 70 à 90 % des patients au bout de cinq ans. Toutefois, il est important de noter que des variations dans la récidive ont été observées entre les études cliniques à répartition aléatoire (ECRA), les études menées dans des centres d’orientation et les études réalisées auprès de la population. Cet article donne un aperçu des stratégies de surveillance et des traitements actuels pour les patients atteints de la MC qui ont subi une entérectomie.
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