First-line surgery in Crohn's disease: who benefits and when?

Crohn's disease (CD) patients often require surgery due to complications such as strictures or fistulas. While historically reserved as a last resort, emerging data suggest that early ileocecal resection (EICR) may provide long-term benefits in selected patients, including reduced need for biologics and lower relapse rates. Identifying which patients are ideal candidates for first-line surgery remains a clinical challenge, but recent studies point toward improved outcomes when surgery is performed in early, localized disease.