Current trends and challenges in the postoperative medical management of Crohn's disease: A systematic review
dc.contributor.advisor | Karim Alavi | |
dc.contributor.author | Schlussel, Andrew T. | |
dc.contributor.author | Cherng, Nicole B. | |
dc.contributor.author | Alavi, Karim | |
dc.date | 2022-08-11T08:10:56.000 | |
dc.date.accessioned | 2022-08-23T17:25:05Z | |
dc.date.available | 2022-08-23T17:25:05Z | |
dc.date.issued | 2017-11-01 | |
dc.date.submitted | 2019-05-29 | |
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.issn | 0002-9610 (Linking) | |
dc.identifier.doi | 10.1016/j.amjsurg.2017.04.016 | |
dc.identifier.pmid | 28666580 | |
dc.identifier.uri | http://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.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. | |
dc.language.iso | en_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.url | https://doi.org/10.1016/j.amjsurg.2017.04.016 | |
dc.subject | Digestive System Diseases | |
dc.subject | Gastroenterology | |
dc.subject | Health Services Administration | |
dc.subject | Medical Education | |
dc.subject | Surgery | |
dc.subject | Surgical Procedures, Operative | |
dc.title | Current trends and challenges in the postoperative medical management of Crohn's disease: A systematic review | |
dc.type | Journal Article | |
dc.source.journaltitle | American journal of surgery | |
dc.source.volume | 214 | |
dc.source.issue | 5 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/ssp/270 | |
dc.legacy.embargo | 2017-01-01T00:00:00-08:00 | |
dc.identifier.contextkey | 14609252 | |
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.submissionpath | ssp/270 | |
dc.contributor.department | Senior Scholars Program | |
dc.contributor.department | School of Medicine | |
dc.contributor.department | Department of Surgery | |
dc.source.pages | 931-937 |