Background: Recurrence is a common event after surgical resections secondary to Crohn's
disease (CD). Endoscopic signs of inflammation, defined as postoperative endoscopic recurrence
(PER) occur in up to 90% of the patients after one year. PER precedes clinical recurrence and further
need for reoperations due to consequent bowel damage. Therefore, controlling inflammation after surgery
in a preventive way is essential for disease control.
Objective: to review data regarding PER in CD, and demonstrate algorithms for its management after
Results: There is no fixed strategy to prevent recurrence after surgery in CD. There are several risk
factors that must be taken into consideration to guide physicians to choose the best therapeutic agents
and strategies in this scenario. In this review, the authors describe in details the stratification based on
risk factors, the therapeutic agents mostly used to prevent recurrence and discuss the several options
for the postoperative management in CD.
Conclusions: No fixed strategy is recommended after surgical resections in CD. Thus, the need for a personalized
approach for each patient is emphasized, in accordance with several conditions and variables.