JLE

Hépato-Gastro & Oncologie Digestive

MENU

How to manage postoperative recurrence in Crohn's disease in 2010? Volume 17, special issue 4, Volume 17, numéro spécial 4

Figures

See all figures

Authors
Inserm, U954, Service d'hépato-gastroentérologie, CHU de Nancy, Allée du Morvan, 54511 Vandoeuvre

Approximately 80% of Crohn's disease patients will require surgery in their lifetime. While surgery removes the diseased intestine, it is not curative and it doesn't prevent recurrence. The postoperative management of Crohn's disease patients offers a challenge for physicians in terms of diagnosing recurrence, minimizing risk factors for recurrence, and selecting patients for therapies to prevent recurrence. In the absence of universally adopted guidelines, clinicians and patients must discuss and balance risks and benefits of postoperative pharmacotherapy. Low-risk patients are considering being those without risk factors or those with long-standing Crohn's disease who come to their first surgery for a short stricture and they may not require treatment. Patients with more aggressive disease and a high risk of recurrence may be best treated early in the postoperative period with an immunomodulator or anti-tumor necrosis factor agent. An ileocolonoscopy should be performed in all patients 6-12 months after surgery with careful inspection of surgical anastomosis and ileoterminal ileum.