Medical prevention of postoperative recurrence of Crohn’s Disease: The state of the art

Post operative recurrence (POR) is for both patient and treating physician one of the most frustrating complications of Crohn’s disease (CD). Conventional medications have been proven of little benefit to prevent POR. By contrast, anti-TNF agents do appear very effective to prevent this complication. Likely, their use may completely change the management paradigm of POR itself and of the native disease as well. Here we will briefly review the definition, the main modalities of diagnosis and the risk factors for POR. We will then focus on the various medications and approaches used to prevent POR and on possible long term strategies. We will then propose a potential algorithm and discuss some of the current open issues to prevent POR.