The Role Of Upfront Surgery in the Management of Ileal Crohn’s Disease

Authors

  • Paulo Gustavo Kotze, MD Health Sciences Postgraduate Program, Catholic University of Paraná (PUCPR), Curitiba, Brazil

DOI:

https://doi.org/10.58931/cibdt.2024.2228

Abstract

Crohn's disease (CD) is a chronic inflammatory disorder characterized by transmural inflammation that can affect any part of the gastrointestinal tract. Among the various phenotypes of CD, involvement of the terminal ileum, known as ileal CD, poses unique challenges in management due to its potential for complications such as strictures, fistulas, and abscesses. While medical therapy remains a cornerstone in the management of CD, the role of surgery, particularly upfront surgical intervention (early resection), has garnered increasing attention in recent years. 

The decision to pursue surgical intervention at the outset of disease management, rather than relying solely on medical therapy, is a subject of ongoing debate in the field. Upfront surgery (prior to advanced medical therapies) may offer benefits such as rapid resolution of symptoms, avoidance of long-term immunosuppressive therapy and prevention of disease progression. However, concerns regarding the postoperative morbidity and potential for recurrence associated with surgical intervention warrant careful consideration.

Author Biography

Paulo Gustavo Kotze, MD, Health Sciences Postgraduate Program, Catholic University of Paraná (PUCPR), Curitiba, Brazil

Paulo Gustavo Kotze is Adjunct Senior Professor of Surgery of the Colorectal Surgery Unit at Cajuru University Hospital of the Catholic University in Curitiba, Paraná, Brazil. He received his medical degree at the Federal University of Paraná in 1997 and completed his General Surgery training at the Evangelical University Hospital in Curitiba (2000). He also completed his senior Fellowship in Colorectal Surgery at the Clinics Hospital from the Federal University of Parana (2002). Dr. Kotze achieved his Masters' Degree on Surgery at the Catholic University in 2008 and joined the faculty of medicine at the same university in 2011, as assistant professor of surgery. He achieved his PhD degree studying the influence of biological therapy on surgical outcomes in Crohn´s disease, in the University of Campinas, in São Paulo, Brazil (UNICAMP) in 2015. Dr. Kotze was also an IBD advanced visiting fellow in the IBD unit at the University of Calgary (Cumming school of medicine), Canada, for the period of 2017- 2018. Currently, he is Professor of the Postgraduate Health Sciences Program at the Catholic University of Paraná. Dr. Kotze is an experienced academic IBD surgeon and author of 3 books, more than 200 PubMed peer-reviewed articles and multiple book chapters focused on Crohn´s disease and ulcerative colitis. He has special interest in the fields of surgery, biological therapy and epidemiology in IBD. He actively participates on the directory board of the Brazilian Study group for IBD (GEDIIB) and is currently co-editor of the Journal of Coloproctology (periodical of the Brazilian society of colorectal surgeons) and participates as an international editorial board member of the Lancet Gastroenterology and Hepatology, Journal of Crohn’s and Colitis, Colorectal Disease, Intestinal Research, Therapeutic Advances in Gastroenterology, Techniques in Coloproctology and the British Journal of Surgery. He is also a reviewer for several international journals such as Gut, Alimentary Pharmacology and Therapeutics, Clinical Gastroenterology and Hepatology, Gastroenterology, among others. Dr. Kotze was formerly a committee member of S-ECCO (surgeons of ECCO) from 2015-2018 and a member of the ECCO EduCOM (educational committee), from 2018-2022. In 2020, he was selected as a full active member of IOIBD (International Organization for the Study of Inflammatory Bowel Disease). He is also a senior researcher of the Brazilian National Research Council (CNPq). 

References

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Published

2024-09-11

How to Cite

1.
Gustavo Kotze P. The Role Of Upfront Surgery in the Management of Ileal Crohn’s Disease. Can IBD Today [Internet]. 2024 Sep. 11 [cited 2024 Oct. 16];2(2):5–9. Available from: https://canadianibdtoday.com/article/view/2-2-Gustavo_Kotze

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