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Laparoscopic ileocaecal resection vs infliximab for terminal ileitis in Crohn disease: Retrospective long-term follow-up of the LIR!C trial

The Lancet: Gastroenterology & Hepatology Jul 05, 2020

Stevens TW, Haasnoot ML, D'Haens GR, et al. - Given that laparoscopic ileocaecal resection represents a cost-effective treatment that has been shown to confer similar quality-of-life outcomes compared with treatment with infliximab, an anti-tumour necrosis factor (TNF) drug, in the LIR!C trial, so, researchers compared long-term results of both interventions as well as explored baseline factors related to the span of treatment impact in each group, via this retrospective follow-up study. Participants were adult patients with non-stricturing and immunomodulator-refractory ileocaecal Crohn's disease who took part in the LIR!C trial. Overall 18 (26%) of 69 patients in the resection group initiated anti-TNF therapy and none needed a second resection. A Crohn disease-related resection was reported in 31 (48%) of 65 patients in the infliximab group. In both groups, a similar duration of treatment effect was noted. Overall, based on these findings, laparoscopic ileocaecal resection was further supported as a management choice for patients suffering from Crohn disease with limited (affected segment ≤40 cm) and mainly inflammatory terminal ileitis for whom conventional management is not successful.

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