[Comparison between staged surgery and one-stage surgery in active complex Crohn disease]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Inflammatory Bowel Disease Research

Background:

• Active complex Crohn disease (CD) presents significant management challenges.
• Surgical intervention is often necessary for complicated CD cases.
• The choice between staged and one-stage surgery impacts patient outcomes.

Purpose of the Study:

• To compare the postoperative prognosis of staged surgery versus one-stage surgery in patients with active complex Crohn disease.
• To evaluate the efficacy of different surgical approaches in managing severe CD complications.

Main Methods:

• Retrospective analysis of clinical data from 33 patients with active complex CD.
• Inclusion criteria: CDAI > 220, long-term steroid use, or severe malnutrition.
• Surgical procedures (staged vs. one-stage) determined by experienced surgeons; patients received immunosuppressants and nutritional support.

Main Results:

• Staged surgery (19 patients) had significantly lower postoperative complication rates (26%) compared to one-stage surgery (14 patients, 71%).
• Early clinical recurrence within 3 months was 0% for staged surgery versus 36% for one-stage surgery.
• Staged surgery demonstrated superior cumulative probabilities for both clinical and endoscopic recurrence.

Conclusions:

• Staged surgery is associated with a higher success rate in managing active complex Crohn disease.
• This approach significantly reduces postoperative complications and early relapse.
• Staged surgery offers a better long-term prognosis by decreasing recurrence rates.