J Curr Surg

Journal of Current Surgery, ISSN 1927-1298 print, 1927-1301 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Curr Surg and Elmer Press Inc

Journal website https://jcs.elmerpub.com

Original Article

Volume 16, Number 2, September 2026, pages 40-48

Early Surgery in Crohn’s Disease: Clinical and Evolutionary Profile

↓ Figure 1. Kaplan–Meier survival curve for (a) postoperative recurrence-free survival in early and late surgery groups; (b) postoperative adverse outcome-free survival in early and late surgery groups; (c) reoperation-free survival in early and late surgery groups; (d) corticosteroid-free survival in early and late surgery groups.

↓ **Table 1.** Clinical and Biological Characteristics of the Patients at Diagnosis
Parameters	Subcategory	Percentage (%)	Mean values (extremes)
IBD: inflammatory bowel disease; BMI: body mass index; BIS: biological inflammatory syndrome; Hb: hemoglobin; WBC: white blood count; CRP: C-reactive protein.
Age at onset (Montreal classification)	A1	6.7	39 ± 14 (16–73)
	A2	51.6
	A3	41.7
Sex	Male	55	Sex ratio (male/female) = 1.22
	Female	45
Smoking status	Non-smokers	57.1	—
	Active smokers	42.9	—
Family history of IBD	—	16.7	—
BMI (kg/m²)	Underweight	18.4	22.8 ± 5.2 (13.3–38.7)
	Normal	51.8
	Overweight	20.2
	Obesity	9.6
Initial presentation	Chronic diarrhea	47.1
	Subocclusive syndrome	16.8
	Abdominal pain	14.3
	Acute intestinal obstruction	10
	Other	11.8
Disease location (Montreal classification)	L1	43.3	—
	L2	14.2	—
	L3	42.5	—
Disease behavior (Montreal classification)	B1	33.3	—
	B2	40.8	—
	B3	25.9	—
	P (perianal)	23.3	—
Anemia	—	67.7	Hb: 11.9 ± 2.3 (2.47–16.4)
BIS	—	54	WBC: 9,513 ± 4,761 (3,000–28,900)
			CRP: 46.8 ± 50.8 (0–238)
			Platelets: 381,819 ± 158,102 (127,000–975,000)

↓ Table 1. Clinical and Biological Characteristics of the Patients at Diagnosis

Parameters

Subcategory

Percentage (%)

Mean values (extremes)

IBD: inflammatory bowel disease; BMI: body mass index; BIS: biological inflammatory syndrome; Hb: hemoglobin; WBC: white blood count; CRP: C-reactive protein.

Age at onset (Montreal classification)

6.7

39 ± 14 (16–73)

51.6

41.7

Sex

Male

Sex ratio (male/female) = 1.22

Female

Smoking status

Non-smokers

57.1

—

Active smokers

42.9

—

Family history of IBD

—

16.7

—

BMI (kg/m²)

Underweight

18.4

22.8 ± 5.2 (13.3–38.7)

Normal

51.8

Overweight

20.2

Obesity

9.6

Initial presentation

Chronic diarrhea

47.1

Subocclusive syndrome

16.8

Abdominal pain

14.3

Acute intestinal obstruction

Other

11.8

Disease location (Montreal classification)

43.3

—

14.2

—

42.5

—

Disease behavior (Montreal classification)

33.3

—

40.8

—

25.9

—

P (perianal)

23.3

—

Anemia

—

67.7

Hb: 11.9 ± 2.3 (2.47–16.4)

BIS

—

WBC: 9,513 ± 4,761 (3,000–28,900)

CRP: 46.8 ± 50.8 (0–238)

Platelets: 381,819 ± 158,102 (127,000–975,000)

↓ **Table 2.** Postoperative Outcomes in Early Versus Late Surgery Groups
Outcome	Early surgery (%)	Late surgery (%)	P
Clinical recurrence	46	42	0.56
Endoscopic recurrence	41.9	53.8	0.37
Adverse outcomes (abscesses/stricture)	25.8	23	0.588
Reoperation	16.1	3.8	0.0132
Corticosteroid treatment	22.5	19.2	0.757
Therapy optimization	35.5	30.8	0.7

↓ Table 2. Postoperative Outcomes in Early Versus Late Surgery Groups

Outcome

Early surgery (%)

Late surgery (%)

Clinical recurrence

0.56

Endoscopic recurrence

41.9

53.8

0.37

Adverse outcomes (abscesses/stricture)

25.8

0.588

Reoperation

16.1

3.8

0.0132

Corticosteroid treatment

22.5

19.2

0.757

Therapy optimization

35.5

30.8

0.7

↓ **Table 3.** Factors Associated With Early Surgery in Univariable and Multivariable Analysis
Univariable analysis	Multivariable analysis
BMI: body mass index; ICV: ileocecal valve; CD: Crohn’s disease; OR: odds ratio; CI: confidence interval.
Nutritional status			0.05	1.56 (0.97–2.51)
Malnutrition	7 (22.5%)	14 (15.7%)
Normal BMI	20 (64.5%)	39 (43.8%)
Overweight	2 (6.5%)	21 (23.6%)
Obesity	1 (3.2%)	10 (11.2%)
Initial presentation			< 0.001	7.39 (2.31–23.65)
Intestinal obstruction	8 (25.8%)	4 (4.5%)
Subocclusive symptoms	8 (25.8%)	12 (13.5%)
Chronic diarrhea	3 (9.7%)	53 (59.6%)
Abdominal pain	6 (19.4%)	11 (12.4%)
Other	6 (19.4%)	9 (10%)
CD location			0.025	2.69 (1.25–5.79)
L1	19(61.3%)	33(37.1%)
L2	1 (3.2%)	16 (18%)
L3	11 (35.5%)	40 (44.9%)
CD behavior			< 0.001	0.042 (0.01–0.29)
B1	1 (3.2%)	39(43.8%)
B2	15 (48.4%)	34 (38.2%)
B3	15(48.4%)	16 (18%)
Endoscopic findings			0.013	3.09 (1.25–7.64)
ICV stenosis	8 (25.8%)	9 (10.1%)
Ulcerated ileitis	3 (9.7%)	25 (28.1%)
Ulcerated ileocolitis	6 (19.4%)	20 (22.5%)
Other	9 (29%)	27 (30.3%)
Complication at first imaging			< 0.001	10.33 (3.907–27.332)	0.02
Yes	21 (67.7%)	14 (15.7%)
No	10 (32.3%)	75 (84.3%)
Corticosteroids at diagnosis			0.005	3.47 (1.42–8.47)	0.016
Yes	9 (29%)	52 (58.4%)
No	22 (71%)	37 (41.6%)

↓ Table 3. Factors Associated With Early Surgery in Univariable and Multivariable Analysis

Univariable analysis

Multivariable analysis

Variable

Early surgery (n = 31)

Late/no surgery (n = 89)

P value

OR (CI)

P value

BMI: body mass index; ICV: ileocecal valve; CD: Crohn’s disease; OR: odds ratio; CI: confidence interval.

Nutritional status

0.05

1.56 (0.97–2.51)

Malnutrition

7 (22.5%)

14 (15.7%)

Normal BMI

20 (64.5%)

39 (43.8%)

Overweight

2 (6.5%)

21 (23.6%)

Obesity

1 (3.2%)

10 (11.2%)

Initial presentation

< 0.001

7.39 (2.31–23.65)

Intestinal obstruction

8 (25.8%)

4 (4.5%)

Subocclusive symptoms

8 (25.8%)

12 (13.5%)

Chronic diarrhea

3 (9.7%)

53 (59.6%)

Abdominal pain

6 (19.4%)

11 (12.4%)

Other

6 (19.4%)

9 (10%)

CD location

0.025

2.69 (1.25–5.79)

19(61.3%)

33(37.1%)

1 (3.2%)

16 (18%)

11 (35.5%)

40 (44.9%)

CD behavior

< 0.001

0.042 (0.01–0.29)

1 (3.2%)

39(43.8%)

15 (48.4%)

34 (38.2%)

15(48.4%)

16 (18%)

Endoscopic findings

0.013

3.09 (1.25–7.64)

ICV stenosis

8 (25.8%)

9 (10.1%)

Ulcerated ileitis

3 (9.7%)

25 (28.1%)

Ulcerated ileocolitis

6 (19.4%)

20 (22.5%)

Other

9 (29%)

27 (30.3%)

Complication at first imaging

< 0.001

10.33 (3.907–27.332)

0.02

Yes

21 (67.7%)

14 (15.7%)

10 (32.3%)

75 (84.3%)

Corticosteroids at diagnosis

0.005

3.47 (1.42–8.47)

0.016

Yes

9 (29%)

52 (58.4%)

22 (71%)

37 (41.6%)

↓ **Table 4.** Comparison of the Estimated Overall Follow-Up Duration According to Treatment Group
Estimated follow-up duration	Late surgery	Early surgery	No surgery
	159.2 months	172.2 months	144.65 months
P value	0.003
		0.966

↓ Table 4. Comparison of the Estimated Overall Follow-Up Duration According to Treatment Group

Estimated follow-up duration

Late surgery

Early surgery

No surgery

159.2 months

172.2 months

144.65 months

P value

0.003

0.966

↓ **Table 5.** Time-to-Event Analyses According to Treatment Group
Event	Early surgery (months)	Late surgery (months)	P value (early vs late)	No surgery (months)	P value (early vs no surgery)
New flare-ups	128	201.3	0.027	109	0.241
Postoperative adverse outcome	167.6	258	0.022
Reoperation	209.6	369.6	0.007
Corticosteroid use	160	278	0.048
Therapeutic escalation	127	229.5	0.019	116.5	0.517
Postoperative endoscopic recurrence	118	173.4	0.050

↓ Table 5. Time-to-Event Analyses According to Treatment Group

Event

Early surgery (months)

Late surgery (months)

P value (early vs late)

No surgery (months)

P value (early vs no surgery)

New flare-ups

128

201.3

0.027

109

0.241

Postoperative adverse outcome

167.6

258

0.022

Reoperation

209.6

369.6

0.007

Corticosteroid use

160

278

0.048

Therapeutic escalation

127

229.5

0.019

116.5

0.517

Postoperative endoscopic recurrence

118

173.4

0.050