Early Ileocecal Resection for Crohn’s Disease

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The vast majority of patients with Crohn’s disease receive standard medications after the diagnosis without considering early surgical treatment for localized disease.

OBJECTIVE

This single-center retrospective study’s objective is to evaluate the results of early ileocecal resection (ICR) in patients with localized Crohn’s disease compared to later surgery performed following protracted anti-inflammatory and immunosuppressive medication therapy.

MATERIAL AND METHODS

85 patients with stricturing Crohn’s disease were subjected to a multivariate retrospective analysis. In 30 of them, ileocecal resection was done right away after the diagnosis without any prior medication (early ICR), whereas in 55 of them, surgery was done after receiving medical therapy. Patients in both groups were similar in terms of gender, age, and BMI. The need for medication after the operation, as well as the types and frequency of postoperative complications, were evaluated. A follow-up endoscopy was performed 3 and 6 months after the operation.

RESULTS

The number and frequency of postoperative complications did not vary between the groups. Both groups had a comparable rate of temporary stoma formation (13.3% vs. 10.9%, p=0.08). Differences were found in the number of patients requiring medical treatment (26.6% vs. 78.1%, p<0.001), time to start medical therapy following surgery (15 months vs. 2 months, p<0.001), and the frequency of therapy escalation (3.3% vs. 38.1%, p<0.001).

CONCLUSION

Early ileocecal resection decreases the requirement for medical therapy in a considerable number of cases and prolongs the time before Crohn’s disease relapses.

Keywords:

Crohn’s disease

Ileocecal resection

Inflammatory bowel disease

Surgery

Authors:

Danilov M.A.

A.S. Loginov Moscow Clinical Scientific Center Department of Health of Moscow

ORCID: 0000-0001-9439-9873

Demidova A.A.

A.S. Loginov Moscow Clinical Scientific Center Department of Health of Moscow

ORCID: 0000-0001-5141-1692

Leontev A.V.

A.S. Loginov Moscow Clinical Scientific Center Department of Health of Moscow

ORCID: 0000-0003-3363-6841

Tsvirkun V.V.

A.S. Loginov Moscow Clinical Scientific Center Department of Health of Moscow

ORCID: 0000-0001-5169-2199

Received:

04.04.2023

Accepted:

20.06.2023

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