Children with Localized Crohn's Disease Benefit from Early Ileocecal Resection and Perioperative Anti-Tumor Necrosis Factor Therapy

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Introduction In pediatric Crohn's disease ileocecal resection is performed reluctantly as postoperative recurrence is frequent. Anti-tumor necrosis factor (TNF) therapy reduces postoperative recurrence rates but increases the risk for infections. Materials and Methods We retrospectively reviewed pediatric Crohn's disease patients who underwent ileocecal resection in our center. We compared disease activity and z-scores for height, weight, and body mass index of patients, who continuously received perioperative anti-TNF therapy (TNF + ), with those who did not (TNF–). Results Of 29 patients (48% females), 13 and 16 were grouped to TNF+ and TNF–, respectively. Patients' characteristics did not differ between groups, except a longer follow-up time in TNF–. We saw significant postoperative improvement but no normalization in z-scores for weight (1.78 vs. 0.77, p

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Article · Mar 2023 · 1 min read

In brief

This retrospective study evaluates outcomes of ileocecal resection in pediatric Crohn's disease patients, comparing those receiving continuous perioperative anti-TNF therapy versus those who did not. Results demonstrate significant postoperative improvement in growth parameters, informing surgical timing and perioperative management strategies for localized pediatric Crohn's disease.

Ileocecal resection in pediatric Crohn's disease significantly improves weight z-scores postoperatively, though full normalization is not achieved.
Perioperative anti-TNF therapy shows promise in reducing postoperative recurrence rates in children undergoing ileocecal resection.
Early surgical intervention for localized ileocecal Crohn's disease may benefit pediatric patients when combined with biologic therapy.
Growth parameters (weight, height, BMI z-scores) improve following ileocecal resection regardless of anti-TNF therapy status.
Postoperative recurrence remains a concern in pediatric Crohn's disease, warranting careful patient selection and perioperative management strategies.

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