Surgical Technique

With the growing knowledge of the recurrent nature of CD, surgical treatment has evolved with the goal of preserving as much bowel length as possible. The application of a "bowel-sparing policy", in which only grossly diseased tissue was resected, was found to be reasonable in CD colitis as well as ileitis [18]. In small bowel stricturing disease, the technique of strictureplasty is preferred to resection and it has been shown not to impact on recurrence or postoperative complications [19, 20]'

The effect of the anastomotic technique and CD recurrence has been studied. Clinical studies have had variable results. Retrospective studies have shown lower recurrence rates in both stapled and hand-sewn anastomoses when compared with one another [21, 22]. One non-randomised prospective study found a lower rate of recurrence in patients with stapled anastomoses [23]. As there is no randomised trial of anastomotic technique, at present there is no conclusive evidence that one anastomotic technique is superior to another.

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