Abstract
In 1998, infliximab, an antitumor necrosis factor alpha (anti-TNF-α) antibody, was
approved for use in the treatment of Crohn disease (CD). Since then, other biologic
therapies, including adalimumab and certolizumab pegol (newer anti-TNF-α antibodies),
and natalizumab, an antibody against alpha-4 integrin, have also been approved. Here,
we review the published studies that examine the relationship between pre- and postoperative
biologic therapy and postoperative complications in patients with CD. This body of
literature is composed of numerous small, retrospective, heterogeneous studies that
demonstrate conflicting and varied results. Overall, the receipt of biologic therapy
in the pre- or postoperative period does not appear to significantly increase the
risk of postoperative complications. It is, however, difficult to draw any firm conclusions
based on the existing level of data. In the future, larger prospective studies are
needed to better elucidate the true risks, if any, that the use of biologic therapy
poses to patients with CD requiring operation.
Keywords
Crohn disease - surgery - biologic therapy - postoperative complications
