Global surgical landscape and outcomes in Crohn's disease in the biologics era: a systematic review protocol.

Authors

Chhagan Lal Birda, Hashem M Al-Dujaily, Chimweta I Chilala, April Camilla Roslani, Ashkan Rezazadeh Ardabili, Mythili Menon Pathiyil, Robert Dudkowiak, Virginia Solitano, Shintaro Akiyama, Beatriz Gros, Abel Botelho Quaresma, Paulo Gustavo Kotze, Anuraag Jena, Vishal Sharma, Shaji Sebastian

Published in

BMJ open. Volume 16. Issue 8. Pages e109537. Aug 17, 2026. Epub Aug 17, 2026.

Abstract

Despite numerous studies on surgical outcomes in Crohn's disease (CD), global evidence remains fragmented, with limited synthesis of data on international surgical trends, regional variations and comparative outcomes. This systematic review aims to evaluate the rates of CD-related surgeries in the biologic era and to identify evidence gaps to inform future surgical strategies.
A comprehensive search will be conducted in MEDLINE, Embase, and CINAHL from 9 February 2015 to 10 February 2025. A combination of controlled vocabulary and free-text terms related to surgical interventions and CD will be used to identify relevant literature. Studies eligible for inclusion include observational studies and randomised controlled trials (RCTs). The primary outcome is overall surgical rates in CD. Secondary outcomes include emergency versus elective surgery, minimally invasive vs conventional approaches, disease duration prior to surgery, permanent stoma formation rates, reconstruction approach and postoperative complications. Both adult and paediatric populations are considered. The risk of bias will be assessed independently by reviewers using appropriate tools. Meta-analyses or narrative synthesis will be conducted based on study heterogeneity, with subgroup and sensitivity analyses to explore regional, temporal and methodological variability.
This protocol does not require ethical approval, as it involves secondary data analysis. Findings will be disseminated via peer-reviewed journal publications and relevant conferences.
CRD420251006137.

PMID:
42608041
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

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