We read with interest the article by Waterman et al,1 ‘Preoperative biological therapy and short-term outcomes of abdominal surgery in patients with inflammatory bowel disease (IBD)’. The authors had conducted a retrospective study evaluating the impact of preoperative biological therapy on complications after surgery for IBD. Preoperative treatment with tumour necrosis factor-α antagonists was not associated with postoperative infectious complications, anastomotic leaks and other perioperative complications. Based on these results, they do not recommend altering antitumour necrosis factor therapy, or the scheduling of surgery to prolong the time interval to operation.

We agree with the authors' recommendation. Surgery should not be delayed, and appropriate biological therapy should be continued perioperatively. However, surgeons would like to know whether they should avoid anastomosis, or create …