TNF and inflammatory bowel disease: Surgery can play a significant role in the management of IBD; however, postoperative recurrence of IBD has been observed in up to 73% of patients, with the presence of endoscopic lesions, although a smaller proportion of patients may exhibit symptoms.155,156 Randomized clinical studies have examined a variety of agents for the prevention of endoscopic and clinical postoperative recurrence, with guidelines recommending the use of imidazole antibiotics, thiopurines and TNF inhibitors as preventive therapies.58