Modern view of surgical treatment of the lesion ileocecal zone in Crohn’s disease: when and how to operate

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Abstract

Crohn’s disease is an inflammatory bowel disease with a chronic recurrent course and a high risk of complications. Crohn’s disease prevalence has been increasing. Despite the era of biological therapy and new therapeutic approaches in the treatment of Crohn’s disease, the role of surgical treatment remains high. This study aimed to analyze the current trends and approaches of surgical treatment localized lesions of ileocecal zone in children with Crohn’s disease. The scientific databases eLibrary, GoogleScholar, MEDLINE, and Embase were searched. The search time interval was 2017–2024. In several recent articles, a trend toward early ileocecal resection in patients with Crohn’s disease was noted. According to some studies in adults, this approach is an alternative option for medical treatment. The advantages of early surgical approach includes decreased surgical complication level, improving the quality of life and reducing the cost of treatment. The timing of early surgical intervention varies. Notably, Crohn’s disease in children has more aggressive character, and early surgical intervention may not only create a therapeutic window of opportunity to control Crohn’s disease but also contribute to improving the long-term results of Crohn’s disease treatment. The role of surgical technique is being studied (the need to include a mesentery with fat wrapping into a resection area or not), the effect of the type of anastomosis on relapse of Crohn’s disease. Analysis of the safety of Kono-S anastomosis and its impact on development recurrence has shown a number of advantages over traditional anastomosis. However, its application in the practice of pediatric surgeons remains isolated. Similar studies are required in children to determine the optimal strategy for the treatment of Crohn’s disease in ileocecal region (determining the role of surgical treatment and type of anastomosis in achieving long-term and deep remission), preventing recurrence of Crohn’s disease and repeated intestinal resections.

About the authors

Victoria A. Glushkova

Saint-Petersburg State Pediatric Medical University

Author for correspondence.
Email: pedsurgspb@yandex.ru
ORCID iD: 0009-0002-4768-1539
SPIN-code: 8703-3966

MD

Russian Federation, 2 Litovskaya st., Saint Petersburg, 194100

Aleksei V. Podkamenev

Saint-Petersburg State Pediatric Medical University

Email: av.podkamenev@gpmu.org
ORCID iD: 0000-0001-6006-9112
SPIN-code: 7052-0205

 MD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, 2 Litovskaya st., Saint Petersburg, 194100

Tatyana V. Gabrusskaya

Saint-Petersburg State Pediatric Medical University

Email: tatyanagabrusskaya@yandex.ru
ORCID iD: 0000-0002-7931-2263
SPIN-code: 2853-5956

MD, Cand. Sci. (Medicine)

Russian Federation, 2 Litovskaya st., Saint Petersburg, 194100

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