Advances in surgical approaches to Crohn's disease: minimally invasive surgery and biologic therapy.

In the last 5 years, significant advances have been made in the surgical approaches to, and medical management of, Crohn's disease (CD). This review summarizes these advances as they relate to the care of surgical patients with CD, with an emphasis on innovations in surgical techniques, specifically minimally invasive (laparoscopic) surgery, as well as on recent developments in biologic pharmacotherapies for CD that have important clinical implications for surgical patients. These include recent insights gained into the role of biologic therapy with infliximab and other newer agents in preoperative and postoperative therapy of CD patients. We will also review other recent developments relevant to the current and future surgical care of CD patients, including the treatment of less common forms of CD, such as duodenal and colonic CD, and the role of novel strategies such as fibrin glue, fistula plugs and stem cell therapy for the treatment of fistulizing anorectal CD.