Surgical interventions in inflammatory bowel disease: Indications, techniques, outcomes, and future directions

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), is a chronic relapsing condition in which surgical intervention remains a cornerstone of management despite advances in medical therapy. Surgery plays a definitive role in UC and a complication-directed, bowel-preserving role in CD. Aim To provide a comprehensive narrative overview of contemporary surgical management in IBD, focusing on indications, operative strategies, perioperative optimization, postoperative outcomes, and future directions. Methods A narrative review was conducted following the principles of the PRISMA 2009 guidelines. A comprehensive literature search of PubMed/MEDLINE, EMBASE, Scopus, and the Cochrane Library was performed for studies published between January 2000 and December 2024. Relevant original studies, systematic reviews, and meta-analyses addressing surgical interventions in adult IBD patients were included. Evidence was synthesized descriptively. Results Surgical indications in UC include medically refractory disease, dysplasia or malignancy, and life-threatening complications, with restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) representing the standard elective procedure. In CD, surgery is primarily indicated for fibrostenotic and penetrating complications, with emphasis on bowel-sparing approaches such as limited re

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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