Increasing Rates of Bowel Resection Surgery for Stricturing Crohn's Disease in the Biologic Era

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Inflammatory Bowel Disease Research

Background:

• The introduction of biologic therapies has coincided with a decline in surgeries for Crohn's disease (CD).
• However, the specific impact of biologics on surgeries for stricturing CD remains unclear.
• This study investigates trends in bowel resection for obstruction in CD patients during the biologic era.

Purpose of the Study:

• To assess nationwide trends in bowel resection surgery for obstruction in Crohn's disease (CD) patients.
• To evaluate the impact of biologic therapies on surgical rates for stricturing CD.
• To identify factors associated with bowel resection for obstruction in CD.

Main Methods:

• A nationwide analysis of hospitalizations for CD was conducted using the Nationwide Inpatient Sample (1998-2020).
• Patients undergoing bowel resection for obstruction were identified.
• Longitudinal trends and multivariable logistic regression were used to analyze data.

Main Results:

• Overall CD-related resections decreased from 12.0% to 6.9% of hospitalizations.
• Resections for obstructive CD increased from 1.3% to 2.0% of hospitalizations.
• The proportion of resections for obstruction among all CD resections rose from 10.8% to 29.1%.

Conclusions:

• While biologics have decreased overall CD surgeries, resections for obstructive disease have increased.
• These findings suggest medical therapy impacts overall surgical rates but has limited effect on stricturing CD.
• Further research into managing stricturing Crohn's disease is warranted.