What's the best surgical management for Crohn's disease?

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  • Subtotal colectomy and ileorectal anastomosis (STC) and segmental colectomy (SC) are both effective methods of surgical management of Crohn's disease (CD).

Why this matters

  • Although total proctocolectomy (TPC) is considered highly effective, this meta-analysis suggests STC and SC may be preferable.

Key results 

  • There was no difference in overall or surgical recurrence of CD between STC and SC patients (OR, 1.24).
  • STC had higher overall and surgical recurrence risk compared with TPC (OR, 3.53 [P<.0001]; OR, 3.52 [P<.0001], respectively).
  • SC had a higher risk for adverse events than STC (OR, 2.84; P=.02), and STC had a lower risk than TPC (OR, 0.19; P<.0001).
  • SC had a lower incidence of stoma formation than STC (OR, 0.26;...