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Different current surgical treatment strategies are discussed based on disease location.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Several surgical options are possible in medically refractory or complex Crohn\u2019s disease as a last resort therapy. Recent evidence indicated that surgery could also be a good alternative in terms of effectiveness, quality of life and costs as first-line therapy if biologicals are considered, e.g. ileocolic resection for limited disease, or as part of combination therapy with biologicals, e.g. surgery aiming at closure of select perianal fistula in combination with biologicals.<\/jats:p>\n                    <jats:p>The role of the mesentery in ileocolic disease and Crohn\u2019s proctitis is an important surgical dilemma. In proctectomy, evidence is directing at removing the mesentery, and in ileocolic disease, it is still under investigation. Other surgical dilemmas are the role of the Kono-S anastomosis as a preventive measure for recurrent Crohn\u2019s disease and the importance of (non)conventional stricturoplasties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Surgical management of Crohn\u2019s disease remains challenging and is dependent on disease location and severity. Indication and timing of surgery should always be discussed in a multidisciplinary team. It seems that early surgery is gradually going to play a more important role in the multidisciplinary management of Crohn\u2019s disease rather than being a last resort therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00384-021-03857-2","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T03:03:23Z","timestamp":1612235003000},"page":"1133-1145","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":100,"title":["Surgical management of Crohn\u2019s disease: a state of the art review"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0932-228X","authenticated-orcid":false,"given":"Elise Maria","family":"Meima - van Praag","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9425-8683","authenticated-orcid":false,"given":"Christianne Johanna","family":"Buskens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6094-8950","authenticated-orcid":false,"given":"Roel","family":"Hompes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1037-9945","authenticated-orcid":false,"given":"Wilhelmus Adrianus","family":"Bemelman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"3857_CR1","doi-asserted-by":"publisher","first-page":"829040","DOI":"10.1155\/2013\/829040","volume":"2013","author":"M Gasparetto","year":"2013","unstructured":"Gasparetto M, Guariso G (2013) Highlights in IBD epidemiology and its natural history in the paediatric age. 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