Background: Crohn’s disease (CD) is an inflammatory bowel disease (IBD) that also affects pediatric patients. It frequently presents as a localized disease, affecting the ileocecal area, ileum, or colon. It requires targeted therapy to achieve a good quality of life and long-term control of disease activity. Despite multiple medical therapies available, several patients benefit from surgical treatment. The aim of our study is to demonstrate how an early surgical approach can bring an improvement in disease activity, evaluating the Simple Endoscopic Score for Crohn’s Disease (SES-CD) and the Pediatric Crohn’s Disease Activity Index (PCDAI). Methods: A retrospective multicenter study was carried out from 2008 to 2023, including 29 patients, affected by localized CD. These data were analyzed: demographics, SES-CD, and PCDAI, before and after surgery. The differences between groups were analyzed using Student’s t-test for continuous variables, and Pearson’s Chi-squared test or Fisher’s exact test for categorical variables. Results: The SES-CD significantly decreased from 12 (median, range 1–15) to 0 (median, range 0–6) (p < 0.0001) and the PCDAI decreased from 30 (median, range 10–50) to 0 (median, range 0–15) (p < 0.0001). The rate of patients receiving enteral nutrition decreased from 51.7% preoperatively to 0% postoperatively (p = 0.0001). The rate of antibiotic use decreased from 13.8% to 0% (p = 0.0001). The rate of patients receiving ≥2 drugs decreased from 10.3% to 0% (p = 0.0001). Conclusions: The early surgical approach can be considered an excellent therapeutic strategy in patients with localized CD. Both parameters examined, SES-CD and PCDAI, demonstrated a clear improvement in the endoscopic images and in disease activity.

Giovanni Domenico Tebala, Fanny Massimi, Francesca Duro, Ahmed Abdelsamad, Stefano Avenia, Gian Luca Baiocchi, Andrea Barberis, Chafik Bouzid, Antoine Castel, Graziano Ceccarelli, Andrea Celotti, Nicola Cillara, Nicola Cinardi, Roberto Cirocchi, Maria Conticchio, Giuseppe Currò, Antonella Delvecchio, Raffaele Vincenzo De Rosa, Jacopo Desiderio, Antonio Di Cintio, Fabio Francesco Di Mola, Domenico Di Nardo, Alessia Fassari, Alessandro Gemini, Carlos Augusto Gomes, Gian Luca Grazi, Giuseppe Margani, Alessandro Mazzotta, Luca Morelli, Andrea Muratore, Fabrice Muscari, Edoardo Maria Muttillo, Alberto Patriti, Gaetano Piccolo, Luca Properzi, Alessandro Puzziello, Lucia Romano, Edoardo Rosso, Sara Saeidi, Andrea Sagnotta, Edoardo Saladino, Marcello Giuseppe Spampinato, Laurent Sulpice, Nádia Tenreiro, Paolo Ubiali, Riccardo Memeo, DoS-RAP Collaborative. Ann Hepatobiliary Pancreat Surg -0001;0:. https://doi.org/10.14701/ahbps.26-007