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

Table 7 Early surgery vs prolonged medical therapy in localized ileocaecal Crohn’s disease

Aspect	Early ileocolic resection	Prolonged/optimized medical therapy (e.g., anti-TNF)
Primary aim	Rapid symptom control and removal of diseased segment	Long-term inflammation control and bowel preservation
Short-term outcomes	Faster symptom relief; fewer steroids; good QoL	Avoids surgical risk initially; some avoid surgery long-term
Long-term surgery need	Many will need further surgery over time	Substantial proportion ultimately require surgery
Strategy implications	Favored for stricturing/penetrating localized disease in fit patients	Favored when extensive small bowel involvement or high surgical risk

TNF: Tumor necrosis factor; QoL: Quality of life.