[Terminal ileitis in Crohn's disease-Is primary surgery the better treatment?]

Despite the development and introduction of new pharmaceutical approaches for Crohn's disease, the treatment of these patients still remains a major clinical challenge due to the heterogeneity in the course, degree of inflammation and localization. Over the last decade surgery was mainly reserved for the treatment of complications during the long course of Crohn's disease; however, due to new evidence-based knowledge, primary surgical resection in patients suffering from isolated Crohn's disease of the terminal ileum represents an equally effective alternative to medicinal antibody-based treatment. Even if further randomized and controlled trials are necessary, the currently available follow-up studies show promising data regarding disease progression with a significant reduction in the need for immunosuppression, which is usually necessary in these patients primarily treated by medication. Therefore, in the interdisciplinary decision on treatment early/primary surgical treatment should be considered as an equally effective alternative for a suitable patient collective.