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dc.contributor.advisorKarim Alavi
dc.contributor.authorSchlussel, Andrew T.
dc.contributor.authorCherng, Nicole B.
dc.contributor.authorAlavi, Karim
dc.date2022-08-11T08:10:56.000
dc.date.accessioned2022-08-23T17:25:05Z
dc.date.available2022-08-23T17:25:05Z
dc.date.issued2017-11-01
dc.date.submitted2019-05-29
dc.identifier.citation<p>Am J Surg. 2017 Nov;214(5):931-937. doi: 10.1016/j.amjsurg.2017.04.016. Epub 2017 Jun 6. <a href="https://doi.org/10.1016/j.amjsurg.2017.04.016">Link to article on publisher's site</a></p>
dc.identifier.issn0002-9610 (Linking)
dc.identifier.doi10.1016/j.amjsurg.2017.04.016
dc.identifier.pmid28666580
dc.identifier.urihttp://hdl.handle.net/20.500.14038/49330
dc.description<p>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.</p>
dc.description.abstractBACKGROUND: 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.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=28666580&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1016/j.amjsurg.2017.04.016
dc.subjectDigestive System Diseases
dc.subjectGastroenterology
dc.subjectHealth Services Administration
dc.subjectMedical Education
dc.subjectSurgery
dc.subjectSurgical Procedures, Operative
dc.titleCurrent trends and challenges in the postoperative medical management of Crohn's disease: A systematic review
dc.typeJournal Article
dc.source.journaltitleAmerican journal of surgery
dc.source.volume214
dc.source.issue5
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/ssp/270
dc.legacy.embargo2017-01-01T00:00:00-08:00
dc.identifier.contextkey14609252
html.description.abstract<p>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.</p> <p>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.</p> <p>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.</p>
dc.identifier.submissionpathssp/270
dc.contributor.departmentSenior Scholars Program
dc.contributor.departmentSchool of Medicine
dc.contributor.departmentDepartment of Surgery
dc.source.pages931-937


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