Evaluating the Long-Term Outcomes of Medical and Surgical Treatments in Fibrostenotic Crohn’s Disease Patients Treated with Anti-TNF/Biologic TherapyÇağatay Ak, Süleyman Sayar, Resul Kahraman, Kamil Özdil
Objective: This study analyzed the follow-up findings on hospitalization requirements and clinical activities for fibrostenotic Crohn’s disease (CD) patients who received biological/anti-TNF treatment without undergoing surgery as well as CD patients who were treated medically and surgically. Materials and Methods: This study compared the Harvey-Bradshaw scores, control colonoscopy results, and hospitalization times regarding the long-term follow-ups for fibrostenotic CD patients who’ve undergone surgery and for those who only received medical treatment. In addition, the study analyzed the factors associated with disease activation. Results: The study was consisted of 117 patients receiving anti-TNF therapy. Patients who underwent surgery for stenotic CD had a lower one year Harvey-Bradshaw score and shorter hospitalization regarding their long-term follow-up compared to those who did not undergo surgery. Patients who underwent surgery had a lower albumin level (p < 0.001) and developed perianal CD (p = 0.046) less than those who had not undergone surgery. C-reactive protein elevation (p = 0.024) and smoking (p < 0.001) have been associated with disease activity, and the absence of granuloma (p = 0.003) and neural plexitis (p = 0.006) on the surgical specimen was found to be associated with disease activation. Conclusion: Surgical treatment is seen to improve the quality of life and result in fewer hospitalizations for fibrostenotic CD patients. Also, hypoalbuminemia may be a marker indicating a surgical decision.