PhD defence E.M.J. (Evelien) Beelen

Dissertation in short:

The postoperative management of Crohn's disease is challenging, as postoperative recurrence is common and re-resection rates are high. A knowledge gap exists regarding postoperative risk stratification and the optimal treatment strategy, limiting under- and over-treatment. The aim of this thesis is to enhance knowledge on the postoperative recurrence of Crohn's disease after intestinal resection, with regards to epidemiology, prediction and prevention. The first part of this thesis focuses on epidemiology of intestinal resections and re-resections throughout the past decades. In addition, the risk of cholecystectomy after ileal resection is assessed. The second part describes the postoperative disease course and prediction of postoperative recurrence, specifically the timing of ileocecal resection, isolated inflammation of the ileal blind loop and Paneth cell function. The third part of this thesis focuses on the prevention of postoperative recurrence, with regards to a management strategy incorporating risk stratification and type of postoperative prophylactic medication.