In the management of Crohn's disease, which surgery is most effective for removing obstructions?

The most effective surgery for removing obstructions in the management of Crohn's disease is bowel resection with re-anastomosis. Crohn's disease can lead to strictures and obstructions due to inflammation, scarring, and narrowing of the intestinal lumen.

Bowel resection involves surgically removing the diseased or obstructed segment of the bowel. Following this removal, re-anastomosis is performed to reconnect the healthy remaining sections of the bowel. This method not only addresses the immediate problem of obstruction but also helps preserve as much bowel function as possible, which is crucial in patients with Crohn's disease who may already be experiencing malabsorption or nutritional deficiencies.

The other options, while they might play a part in the overall management of Crohn's disease, do not specifically target obstructions effectively. A colectomy would involve removing the colon, which may not be necessary if the obstruction is in the small intestine where Crohn's disease most commonly occurs. A diverting ostomy could address output but does not remove the obstruction itself. Proctocolectomy with ileostomy involves the removal of both the colon and rectum, which is generally reserved for severe cases and would not be the first line for obstruction management.