Surgery has been a mainstay of therapy for Crohn’s disease for a long time, essentially as a
consequence of the fairly modest efficacy of traditional medications such as immunomodulators, 10
antibiotics and 5-ASA, especially in severe cases. However, in the past decade and half, the
advent of anti-TNF agents has greatly changed the medical approach to this disease and may
modify its general management as well. Here, we have reviewed the current literature on
incidence of surgery, timing of surgery and postoperative recurrence of Crohn’s disease before
and after the advent of anti-TNF agents. In addition, we have reviewed the risk of perioperative 15
complications in patients on anti-TNF agents before surgery. The data show that the use of
these medications is changing or expecting to change shortly a number of surgical aspects of
Crohn’s disease management
