DOP042 Need for ileocaecal resections, but not ileo-colic re-resections, has decreased: a nationwide study of temporal trends in Crohn surgery in Sweden 1990–2014

Kalman, Disa; Nordenvall, Caroline; Everhov, Åsa H; Sachs, Michael; Ludvigsson, Jonas F.; Ekbom, Anders; Myrelid, Pär; Olén, Ola

doi:10.1093/ecco-jcc/jjx180.079

Cited by 1 publication

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“…More recent data from Sweden on the other hand show a very different picture, with the 10-year cumulative incidence of an ileocecal resection having decreased from 40% in patients diagnosed between 1990 and 1995 to 16% in patients diagnosed between 2004 and 2009. Furthermore, the need of a repeated ileocolic resection was as low as 5% after five years, but with no significant temporal changes in ileocolic resection rates seen over the whole time period 1990 to 2014 53 .…”

Section: Surgical Therapymentioning

confidence: 86%

“…In most cases both therapies may be reasonable options as first line therapy, and it may therefore be down to the choice of the patient which therapy is used firsthand. Even though the risk of repeat ileocolic resection is low 53 there is however a subsequent risk of needing either surgery or aTNF as secondary therapy at a later stage and patients should be informed of this as well.…”

Section: Ileitis and Terminal Ileitismentioning

confidence: 99%

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The changing landscape of surgery for Crohn's disease

Levin

Risto

Myrelid

2020

Seminars in Colon and Rectal Surgery

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The incidence of Crohn's disease is increasing world-wide and the disease location and behavior is changing towards more colonic as well as inflammatory behavior. As previous data have spoken towards ileal disease and stricturing and penetrating disease to be the indications most in need of surgery, one could expect the surgical load to decrease. As these changes are relative, the absolute numbers of surgical interventions are less affected. There are also data showing an increasing complexity among patients at time of surgery. Finally, a new role for surgery as initial therapy to induce remission instead of biologic therapy in ileal or ileocaecal disease has been suggested. In order to improve the care for patients with Crohn's disease in general, and the peri-operative phase in particular, the use of multidisciplinary team discussions is essential. In conclusion, the role of surgery is changing.Fewer patients need surgery, but when they do they have more complex disease. In the future, ileocaecal resection may be used increasingly as initial therapy to induce remission in a true top-down approach.

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Section: Surgical Therapymentioning

confidence: 86%

Section: Ileitis and Terminal Ileitismentioning

confidence: 99%