Surgical interventions in inflammatory bowel disease: Indications, techniques, outcomes, and future directions

Table 5 Common operations in Crohn’s disease

Operation/technique	Typical indication	Bowel preservation	Key concerns/outcomes
Ileocolic resection	Terminal ileal CD with obstruction or penetrating disease	Limited	High endoscopic recurrence; anastomotic strategy important
Heineke-Mikulicz strictureplasty	Short (< 10 cm) fibrostenotic small-bowel strictures	High	Good long-term patency; avoid in severe inflammation or dysplasia
Finney/michelassi strictureplasty	Long or multiple strictures, risk of short bowel	Very high	Technically demanding; bacterial overgrowth risk in long segments
Kono-S anastomosis	Ileocolic resection where recurrence risk is high	N/A	Similar morbidity; may reduce anastomotic complications and reintervention
Perianal seton drainage	Complex perianal fistulas with abscess/sepsis	N/A	Essential bridge to medical therapy; often long-term seton use

N/A: Not applicable; CD: Crohn’s disease.