"EMERGING TRENDS IN THE SURGICAL MANAGEMENT OF CROHN'S DISEASE: A COMPREHENSIVE REVIEW OF THE INFLIXIMAB ERA AND FUTURE PERSPECTIVES"

Abstract

Crohn's disease (CD) is a chronic inflammatory bowel disease with a risk of complications and chronicity necessitating surgery in the form of strictures, fistulas, or abscesses. With the advent of biologic therapy, particularly anti-TNF agents like Infliximab, the history of CD management altered drastically, reducing the need for surgery and optimizing long-term disease control. Although this transformed CD treatment, surgical management plays a significant role in managing refractory disease and postoperative recurrence. The review will critically analyze the shifting patterns in surgical management of Crohn's disease with special reference to the role of biologic therapy for surgical considerations and outcomes. The review also mentions future trends in surgical procedures and regimens of biologic therapy. A detailed review of recent peer-reviewed articles, clinical trials, and observational studies was conducted. Studies comparing surgical procedures, biologic therapy, and synergy between the two in managing Crohn's disease were analyzed to provide a complete picture of the current scenario and future trends in management. The review is intended to highlight significant advancements in surgical procedures, like minimally invasive surgery, and the role of biologics like Infliximab in the need and timing of surgery. The review also mentions the prevention of postoperative recurrence by biologics, thereby avoiding long-term surgical interventions. Although biologic therapies have reduced the need for surgery in CD to a great extent, surgery continues to be performed in the subgroup of patients. Future studies must optimize surgical procedures and biologic therapy to enhance patient outcomes further and avoid surgical recurrence.