Inflammatory bowel disease surgery in the biologic era

Area of Science:

• Gastroenterology and Immunology
• Surgical Oncology

Background:

• Anti-tumour necrosis factor (TNF)-α therapies, including infliximab and adalimumab, have transformed inflammatory bowel disease (IBD) treatment.
• These biologics induce remission in moderate to severe Crohn's disease (CD) and ulcerative colitis (UC), shifting treatment goals towards preventing disease progression.
• Despite medical advances, 30%-40% of CD and 20%-30% of UC patients still require surgery.

Purpose of the Study:

• To review the role of surgery in IBD management in the era of biologic therapies.
• To analyze the impact of anti-TNF-α agents on perioperative outcomes and complications.

Main Methods:

• Literature review of studies on biologic agents and surgery in IBD treatment.
• Detailed discussion of perioperative risks and complications associated with anti-TNF-α therapy.

Main Results:

• Biologic therapies play a significant role in IBD medical management.
• Concerns exist regarding the effects of anti-TNF-α agents on postoperative complications and morbidity.
• The review synthesizes current understanding of biologic-surgery interactions in IBD.

Conclusions:

• Surgery remains a crucial component of IBD treatment, even with advanced biologic therapies.
• Understanding and managing the perioperative risks associated with anti-TNF-α agents is essential for optimizing patient outcomes.
• Further research is needed to fully elucidate the long-term impact of biologics on surgical outcomes in IBD.