Commentary: Changing trends in surgery for abdominal Crohn's disease

[Strictureplasty or resection? Optimal approach for fibrostenotic Crohn's disease]

The indications for surgical intervention in patients with Crohn's disease (CD) are ineffective therapy and complications of this disease. In case of fibrostenotic CD, strictureplasty or bowel resection are indicated. The indications for organ-sparing surgeries are multiple small bowel lesions, previous surgery for CD and short bowel syndrome. Strictureplasty is not advisable in patients with fistulas, abscesses, bowel perforation and severe hypoalbuminemia due to extremely high risk of anastomotic leakage. Therefore, bowel resection is recommended if strict indications for various types of strictureplasty are absent. This approach is associated with effective maintenance of remission and longer recurrence-free period.