70-90% of patients with Crohn’s Disease (CD) will eventually need surgery. The likelihood of surgery in CD after initial diagnosis has been reported in a recent systematic review to be 16.3% at one year, 33.3% at three years and 46.6% at 5 years 
Absolute indications for surgery in CD include cancer, perforation, toxic megacolon and major life-threatening gastrointestinal tract (GIT) bleeding. 
Relative indications include strictures, phlegmon, fistulae, intra-abdominal abscesses, GIT bleeding, dysplasia associated lesion or mass (DALM), high grade dysplasia detected on surveillance, growth retardation in children and failure of medical therapy.
The decision of when to operate is difficult in CD. Delaying surgery for prolonged medical management may increase complication rates as well as increasing the technical difficulties encountered during surgery and the rates of emergency surgery, which is associated with increased stoma rates and at least a three-fold increase in mortality compared to elective surgery. 
Please click on our publication below for further information regarding the "Indications and surgical options for small bowel, large bowel and perianal Crohn's Disease".
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