[Surgical treatment for Crohn's disease]

Surgery is mandatory in most patients with Crohn's disease. Crohn's disease refractory to medical treatment represents the main indication for surgery. After intestinal resection, the patient remains exposed to a high risk of recurrence on the remnant bowel. It is the reason why, firstly, intestinal resection for Crohn's disease should be performed without extended resections margins, secondly, it must be restricted to symptomatic lesions, and thirdly, prophylactic therapy should be given postoperatively. The laparoscopic approach is to date more an more proposed in patients with Crohn's disease. It could be the procedure of choice for elective ileocaecal resection. Its use in emergency situations and for more large resections, such as total colectomy followed by ileorectal anastomosis is still under evaluation.