The role of elective surgery in children with localized Crohn’s disease

Abstract

Substantial proportions of children with Crohn’s Disease (CD) are non-responsive to standard medical therapy and/or nutritional treatment. For many children impairment of growth will also be an associated medical problem. Aim: The aim of our study was to investigate a role of elective surgical treatment on the induction and duration of remission, and on growth improvement in paediatric patients with localized CD, who were refractory to conservative treatment. Methods: We retrospectively analyzed the data of 55 newly diagnosed CD patients among whom 22 children (40%) had undergone surgical treatment. Results: Post surgery all patients had significant PCDAI decline and the great majority of them (90.9%) had stable remission for more than 2 years. Following surgery 86.4% patients had a significant improvement in growth: an improvement in Z score for height ranging from 0.2 to 0.5 SD (9 months to 2 years after resection, p<0,01). Conclusion: Elective surgery, if properly timed and in well prepared patients, has a significant relapse preventive and steroid sparing role, and also results in major growth improvement.