Postoperative Crohn's disease.
More than three quarters of patients with Crohn's disease (CD) will require surgery. After resection, disease recurs postoperatively with a median time to second resection of about 10 years. Despite its importance, the postoperative period remains one of the most poorly understood clinical settings in the field. Postoperatively, CD may exhibit unique pathophysiologic features, but the current state of knowledge does not allow for identification of patients at risk for relapse, and leaves clinicians without guidance on optimal maintenance treatment. Therapies used as maintenance for CD in other settings may have different efficacies when used after surgery, and clinical research in patients requiring surgery is limited by the subset of patients available for study. Despite the many limitations in current knowledge of postoperative CD, it is an exciting field because new developments have improved patient care, and ongoing research has the potential for further gains.
Penner
Robert M
RM
Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Canada.
Madsen
Karen L
KL
Fedorak
Richard N
RN
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003113:Colonoscopy; D003424:Crohn Disease / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D019936:Probiotics / Q000627:therapeutic use; D011379:Prognosis; D012086:Reoperation / Q000706:statistics & numerical data; D018570:Risk Assessment; D055502:Secondary Prevention; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents