Targeted Surgery Combined with Postoperative Medical Therapy Is Safe and Effective Treatment for Crohn Disease

Lelievre O, Abdalla S, Carbonnel F, et al. Targeted Surgery Combined with Postoperative Medical Therapy for Residual Disease for Severe and Multifocal Crohn Disease. Surgery (2024).

In patients requiring surgery for complicated Crohn disease, complete removal of all diseased areas of the intestine may cause severe malnutrition and weight loss.

The authors reported outcomes of a retrospective review of patients (n = 30) with multifocal Crohn disease who underwent targeted surgery (removal of severe disease and strictures with at least one area of diseased intestine left behind); the outcome of interest was need for additional surgery for control of residual Crohn disease.

All included patients underwent at least 3 cycles of preoperative medical therapy, and 83% of patients received postoperative medical therapy over a median follow up interval of 65 months. Clinical remission was achieved in 71% of patients at 24 months; reoperation was required in 25% of patients.

The authors concluded that targeted surgery with removal of severe and complicated lesions was safe and effective for management of multifocal Crohn disease.