EARLY ILEOCECAL RESECTION IN CROHN'S DISEASE: A SYSTEMATIC REVIEW

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Inflammatory Bowel Disease Research

Background:

• Crohn's disease (CD) management increasingly involves combination drug therapies.
• Despite advances, up to 80% of patients with ileocecal CD may still require surgery.
• The optimal timing of surgical intervention remains a key clinical question.

Purpose of the Study:

• To qualitatively evaluate outcomes of early surgery versus drug therapy for ileocecal CD.
• To analyze data from both adult and pediatric populations.
• To synthesize existing literature on surgical and medical management strategies.

Main Methods:

• Systematic literature search of the PUBMED database.
• Adherence to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.
• Methodological quality assessment using MINORS (Methodological Index for Non-Randomized Studies) criteria.

Main Results:

• 22 studies were included for qualitative evaluation.
• Higher postoperative morbidity was observed in patients operated for CD complications versus inflammatory phenotype.
• Later-stage surgery was associated with increased CD recurrence and worse long-term clinical control.

Conclusions:

• Early surgical intervention is a strong therapeutic option for uncomplicated, isolated ileocecal CD in adults.
• Drug therapy alone may not suffice for all ileocecal CD cases.
• Further research is needed for pediatric ileocecal CD due to limited study data.