IBD: Step-up vs top-down therapy for Crohn's disease: medicine vs surgery

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Ileocaecal resection has traditionally been reserved for the treatment of biologic-refractory inflammatory, fibrostenotic or fistulizing Crohn's disease of the terminal ileum. Now, for the first time, this surgical approach has been investigated as an initial treatment for steroid or immunomodulator-refractory Crohn's ileitis, in comparison with anti-TNF therapy.Refers to Ponsioen, C. Y. et al. Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn's disease: a randomised controlled, open-label, multicentre trial. Lancet Gastroenterol. Hepatol.http://dx.doi.org/10.1016/S2468-1253(17)30248-0 (2017)

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