The efficacy of biologic agents in Crohn's disease has led to proposals that they be introduced early in the disease.
The aim was to reduce corticosteroid dependency and surgical resection.
However, the long-term use of biologic agents in limited Crohn's disease may be difficult to justify.
|48% of patients remained symptom-free at 10 years|
|Inflammatory Bowel Diseases|
Dr Garret Cullen and colleagues from Ireland assessed outcomes for ileocecal resection in Crohn's disease and evaluated its role in the current era.
The team evaluated 139 Crohn's disease patients who underwent ileocecal resection between 1980 and 2000.
Data were retrieved from a prospectively maintained database.
Disease recurrence was defined as symptoms in addition to endoscopic or radiological evidence of disease activity.
Severe disease recurrence was defined as a need for repeat resection surgery.
The researchers found that 52% of patients developed disease recurrence.
The median time to recurrence was 7 years.
The team noted that 35% of patients required repeat resection surgery.
Median time to repeat surgery was 7 years.
The research team observed that the presence of granulomas was associated with disease recurrence, and repeat resection surgery.
Dr Cullen's team concluded, "Long-term outcomes for ileocecal resection in Crohn's disease are excellent with 48% of patients remaining symptom-free, and only 35% requiring repeat resection surgery at 10 years."
"This should be borne in mind when considering biologic therapy."