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    Current trends and challenges in the postoperative medical management of Crohn's disease: A systematic review

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    Authors
    Schlussel, Andrew T.
    Cherng, Nicole B.
    Alavi, Karim
    Faculty Advisor
    Karim Alavi
    UMass Chan Affiliations
    Senior Scholars Program
    School of Medicine
    Department of Surgery
    Document Type
    Journal Article
    Publication Date
    2017-11-01
    Keywords
    Digestive System Diseases
    Gastroenterology
    Health Services Administration
    Medical Education
    Surgery
    Surgical Procedures, Operative
    
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    Link to Full Text
    https://doi.org/10.1016/j.amjsurg.2017.04.016
    Abstract
    BACKGROUND: Crohn's disease is an aggressive chronic inflammatory disorder, and despite medical advances no cure exists. There is a great risk of requiring an operative intervention, with evidence of recurrence developing in up to 80-90% of cases. Therefore, we sought to systematically review the current status in the postoperative medical management of Crohn's disease. DATA SOURCES: A systematic literature review of medications administered following respective therapy for Crohn's disease was performed from 1979 through 2016. Twenty-six prospective articles provided directed guidelines for recommendations and these were graded based on the level of evidence. CONCLUSIONS: The postoperative management of Crohn's disease faces multiple challenges. Current indicated medications in this setting include: antibiotics, aminosalicylates, immunomodulators, and biologics. Each drug has inherent risks and benefits, and the optimal regimen is still unknown. Initiating therapy in a prophylactic fashion compared to endoscopic findings, or escalating therapy versus treating with the most potent drug first is debated. Although a definitive consensus on postoperative treatment is necessary, aggressive and early endoluminal surveillance is paramount in the treatment of these complicated patients.
    Source

    Am J Surg. 2017 Nov;214(5):931-937. doi: 10.1016/j.amjsurg.2017.04.016. Epub 2017 Jun 6. Link to article on publisher's site

    DOI
    10.1016/j.amjsurg.2017.04.016
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/49330
    PubMed ID
    28666580
    Notes

    Nicole B. Cherng participated in this study as a medical student as part of the Senior Scholars research program at the University of Massachusetts Medical School.

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    ae974a485f413a2113503eed53cd6c53
    10.1016/j.amjsurg.2017.04.016
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