J.Jpn. Surg. Soc.. 116(2): 82-86, 2015

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Feature topic

CURRENT TRENDS IN THE MANAGEMENT OF CROHN'S DISEASE

The medical therapy of Crohn's disease has improved markedly in recent years. In large part, this was due to the introduction of novel biologics. Biological therapy provides superior efficacy; however, these drugs should be given to selected patients who do not respond to first-line medications because of validated safety concerns like infections and malignancy as well as high cost. It remains unclear whether the preoperative use of biologic agents increases the risk of complications after surgery for Crohn's disease. Further research is necessary to evaluate the impact of biologic therapy on postoperative complications. Recent clinical trials have shown that biologic therapy with infliximab and adalimumab is useful for the prevention of postoperative recurrence of Crohn's disease. Further studies are warranted to determine suitable candidates for postoperative biologic therapy and the best time to start treatment. In the surgical management of Crohn's disease, there has been an increasing trend toward limited resection and the use of strictureplasty to preserve small bowel length. Currently, less invasive laparoscopic surgery is used to treat Crohn's disease, which is safe and feasible.

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