Abstract
Introduction The aim of this study is to evaluate the outcome of introduction of early surgery in the course of isolated ileocecal Crohn's disease, where there is no absolute indication of surgery. Methods Observational study involving patients with isolated ileocecal Crohn's disease who underwent early surgical resection (within one year of the presentation of the hospital). A complete blood count, ESR, and CRP were done and compared between the preoperative value, 1st postoperative visit (3-4 weeks), and last follow-up visit. Statistical analysis was done using Analysis of Variance (ANOVA) to compare the different figures. Results There was a statistically significant increase in the hemoglobin levels between preoperative, postoperative, and long-term follow-up and a significant decrease in leukocyte count between the pre- and postoperative values (F = 19.8, p < 0.001 and F = 8.9, p = 0.002, resp.). Similarly, the ESR and CRP values were decreased significantly at long-term follow-up (F = 8.5, p = 0.019 and F = 8.3, p = 0.013, resp.). Conclusion Early surgical resection in isolated ileocaecal Crohn's disease achieved significant biochemical improvements. These successful results in this small number of patients indicate that early surgical intervention may provide better outcomes. These initial results encourage larger and comparative studies of long-term results versus long-term use of biological agents.
Highlights
The aim of this study is to evaluate the outcome of introduction of early surgery in the course of isolated ileocecal Crohn’s disease, where there is no absolute indication of surgery
While Crohn’s disease can be accompanied by a myriad of extracolonic manifestations, the majority of symptoms related to colonic involvement can include crampy abdominal pain and fluctuant nonbleeding diarrhea, with associated symptoms including fever, weight loss, presence of fistulas, and malabsorptive symptoms
Preop to postop improvement Preop to follow-up improvement agents, surgical intervention has mostly been relegated to being an option of last resort
Summary
The aim of this study is to evaluate the outcome of introduction of early surgery in the course of isolated ileocecal Crohn’s disease, where there is no absolute indication of surgery. Observational study involving patients with isolated ileocecal Crohn’s disease who underwent early surgical resection (within one year of the presentation of the hospital). Surgical resection in isolated ileocaecal Crohn’s disease achieved significant biochemical improvements. These successful results in this small number of patients indicate that early surgical intervention may provide better outcomes. These initial results encourage larger and comparative studies of long-term results versus long-term use of biological agents. Crohn’s disease is an inflammatory bowel disease subtype that involves transmural inflammation of the gastrointestinal tract This inflammation can be present anywhere from the mouth to the perianal area. Ileocaecal resection is one of the surgical modalities, used for ileocaecal Crohn’s disease, and is considered to be the most effective at improving quality of life [3, 4]
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