Intest Res.  2017 Apr;15(2):160-165. 10.5217/ir.2017.15.2.160.

Preoperative use of anti-tumor necrosis factor therapy in Crohn's disease: promises and pitfalls

• Kotze PG
• Ghosh S
• Bemelman W
• Panaccione R

• KMID: 2425156
• DOI: http://doi.org/10.5217/ir.2017.15.2.160

Abstract

Recent advances in medical and surgical therapy were achieved during the last two decades in the management of Crohn's disease (CD). Anti-tumor necrosis factor (anti-TNF) agents are widely used worldwide. However, a significant proportion of patients still need surgical resections. The impact of previous exposure to these agents on the perioperative and postoperative outcomes is still controversial. In this critical review, we aimed to position the strategy of intentional preoperative use of anti-TNF agents in the management of CD. The indications and contraindications for this strategy are detailed, and despite scarce evidence, the possible advantages and disadvantages of the intentional use of anti-TNF agents before abdominal surgery in CD are discussed.

Keyword

Crohn disease; Tumor necrosis factor-alpha; Preoperative care

MeSH Terms

Crohn Disease*
Humans
Necrosis*
Preoperative Care
Tumor Necrosis Factor-alpha
Tumor Necrosis Factor-alpha

Figure

• 

  Fig. 1 Balance between possible theoretical advantages and disadvantages of intentional preoperative anti-tumor necrosis factor (anti-TNF) therapy in patients with CD.

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