Should surgical intervention become a primary treatment modality in Crohn’s disease?—A review of the role of surgery and emerging surgical techniques

Recent advances in surgical techniques mean the position of surgery in the treatment paradigm of Crohn’s disease is changing. For patients with Crohn’s disease, surgical intervention is generally reserved for management of complications or to mitigate symptoms that are not responding to medical treatment. Outcomes following surgery for Crohn’s disease are such that it is increasingly proposed as a primary rather than secondary treatment modality. In addition, techniques involved in the surgical management of Crohn’s disease have developed. Conventional approaches mainly focused on limiting the length of intestinal resection, but ignored radial excision of adjacent mesentery. Increasingly, radial mesenteric resection, coupled with conservative intestinal resection, is being investigated. This article reviews the position of surgery in the overall management of Crohn’s disease as well as emerging techniques surgical techniques.