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Postoperative anastomotic complications in patients with Crohn's disease undergoing ileocolic resections have a detrimental influence on the long-term outcome. The aim of this study was to evaluate whether patients'prognosis is affected by various treatment strategies of anastomotic complications.The term anastomosis-related ‘intraabdominal septic complication’ (IASC) was used for anastomotic leaks, intraabdominal abscesses, anastomotic fistula, peritonitis. Only patients with these complications have been included in the study. Outcome parameters were 'surgical recurrence' (i.e. need for repeat bowel resections) and ‘good surgical outcome’ (i.e. no death, no surgical recurrence, no stoma, no enterocutaneous fistula). Patients in group 1 were treated by taking the affected anastomosis down and creating an end stoma. The anastomosis has beenpreserved in patients of group 2.Between 1992 and 8/2009, IASC occurred after 56 ileocolic resections. The 5-year surgical recurrence rate was lower (0% vs 65%, P = 0.0020) and a good surgical outcome was achieved more frequently at 2 years (100% vs 25%, P = 0.0001) in group 1 than in group 2.In patients with Crohn's disease suffering anastomotic complications after ileocolic resection, theprognosis can be significantly improved by taking down the anastomosis and creating an end ileostomy.