Surgical Management of Benign and Malignant Colorectal Disease in the Immunocompromised Patient

C. Kin, M. Welton, A. Lightner
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Abstract

Patients who are immunosuppressed either due to an underlying disease process or medications to treat a disease require important perioperative considerations. Preoperative evaluation mandates a higher index of suspicion for pathology given that peritoneal and systemic markers of illness may be masked. Intraoperatively, consideration should be given for diversion more frequently than in a nonimmunosuppressed patient. Postoperatively, patients should be managed in a multidisciplinary fashion. This review largely focuses on the immunosuppressive mediations used for the treatment of inflammatory bowel disease, benign colorectal disease in an immunosuppressed patient, and colorectal malignancies in immunosuppressed patients to highlight important considerations for this patient population. This review contains 4 figures, 5 tables, and 78 references. Key words: anal squamous cell carcinoma, appendicitis versus typhlitis, biologic therapy, corticosteroids, human papillomavirus, immunosuppression, neutropenic enterocolitis 
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免疫功能低下患者良恶性结直肠疾病的外科治疗
由于潜在疾病过程或治疗疾病的药物导致免疫抑制的患者需要重要的围手术期考虑。鉴于腹膜和全身疾病的标志物可能被掩盖,术前评估要求更高的病理怀疑指数。术中应比非免疫抑制患者更频繁地考虑转移。术后,患者应以多学科方式进行管理。本综述主要关注用于治疗炎症性肠病、免疫抑制患者的良性结直肠疾病和免疫抑制患者的结直肠恶性肿瘤的免疫抑制药物,以强调这类患者群体的重要注意事项。本综述包含4图5表,78篇参考文献。关键词:肛门鳞状细胞癌,阑尾炎对抗斑疹炎,生物治疗,皮质类固醇,人乳头瘤病毒,免疫抑制,中性粒细胞减少性小肠结肠炎
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