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World J Gastroenterol. Sep 7, 2014; 20(33): 11808-11814
Published online Sep 7, 2014. doi: 10.3748/wjg.v20.i33.11808
Published online Sep 7, 2014. doi: 10.3748/wjg.v20.i33.11808
Impact of medical therapy on patients with Crohn’s disease requiring surgical resection
YT Nancy Fu, Brian Bressler, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, BC V6Z 1Y6, Canada
Thomas Hong, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
Andrew Round, GI Clinic and Gastrointestinal Research Institute, Vancouver, BC V6Z 2K5, Canada
Author contributions: Fu YTN collected, analyzed the data with assistance of a statistician, and drafted the manuscript; Hong T and Round A collected the data; Bressler B designed the study and critically revised the manuscript; all authors participated in the final revision of the manuscript.
Correspondence to: YT Nancy Fu, MD, FRCPC, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul’s Hospital, 770-1190 Hornby Street, Vancouver, BC V6Z 1Y6, Canada. nfu@interchange.ubc.ca
Telephone: +1- 604-6886332 Fax: +1-604-6892004
Received: January 29, 2014
Revised: March 17, 2014
Accepted: April 21, 2014
Published online: September 7, 2014
Revised: March 17, 2014
Accepted: April 21, 2014
Published online: September 7, 2014
Core Tip
Core tip: Comparing two cohorts separated by a decade of Crohn’s disease patients who required surgical resections, this study showed significant changes in patient phenotypes and medication usage. Those that required surgery shifted from more inflammatory to stricturing and penetrating phenotypes, and had more immunomodulators but less 5-aminosalysilic acid exposures. Patients treated with biologics had significantly longer time from Crohn’s disease diagnosis to surgery. However, they were at increased risk for surgery, suggesting that biologics were often used too late in the patients’ treatment courses.