Step-up vs top-down therapy for Crohn's disease: medicine vs surgery

Ileocaecal resection has traditionally been reserved for the treatment of biologic-refractory inflammatory, fibrostenotic or fistulizing Crohn's disease of the terminal ileum. Now, for the first time, this surgical approach has been investigated as an initial treatment for steroid or immunomodulator-refractory Crohn's ileitis, in comparison with anti-TNF therapy.