, Volume 11, Issue 6, pp 791-803
Date: 19 Jan 2007

Surgical Treatment of Crohn’s Disease

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Introduction

Crohn’s disease is an entity which comprises a heterogeneous spectrum of intestinal and extraintestinal manifestations, each one requiring individual approaches for diagnosis and management. Medical management has evolved greatly during the last decade: innovations have included the introduction of new therapeutical agents for prophylaxis and for management of complications. Yet, the introduction of new biologic agents, such as anti-TNF antibody1,2, or immunomodulators, such as azathioprine/6 mercaptopurine3, has not significantly changed the long-term prognosis and natural history of patients with Crohn’s disease4,5. Patients with Crohn’s disease still tend to require surgery as time progresses, and the timing of surgery is critical. This review article will focus on the indications for surgical treatment, on the preoperative evaluation of Crohn’s patients, on surgical options specific to different gastrointestinal locations affected by the disease, and on new minimally in