Temporal trends in surgery for Crohn’s disease: A ten-year single-center retrospective study

Purpose: Crohn’s disease (CD) is a chronic inflammatory bowel disease that requires surgery in many cases. The characteristics of CD surgical patients and the temporal trends in surgical management in China has not been well studied. This article aims to investigate the changes related to CD surgery in China over 10 years Methods: The data of patients underwent abdominal surgery for CD between 2013 and 2022 were collected prospectively. Data were compared between two periods (2013–2017 and 2018–2022). Results: A total of 1059 individuals underwent 1176 surgical procedures, of which 67.1% were male. The median age of patients at the time of surgery was 36.0 years, and an overall increasing trend was observed in surgical volume. The proportion of patients treated with biologics increased from the first period (2013-2017) to the second (2018-2022), rising from 35% to 46% (p< 0.001). In the second stage, the proportion of patients who underwent surgery for abscesses or fistulas increased (47.8% vs. 40.0%), while the percentage of emergency surgeries declined (3.0% vs. 7.1%). Furthermore, there was a rise in the proportion of laparoscopic surgeries (76.5% vs. 63.7%), coupled with a decrease in stoma rates (15.4% vs. 30.5%) and postoperative complications (23.0% vs. 30.5%). Conclusion: The frequency of biologics usage in CD surgery have increased over time, and the proportion of penetrating patients has grown. Minimally invasive surgical methods have become the norm, and surgical outcomes have markedly enhanced, evidenced by a substantial reduction in both stoma rates and complication rates.