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This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND AND AIM Biological therapies may be changing the natural history of inflammatory bowel diseases (IBDs), reducing the need for surgical intervention. We aimed to assess whether the availability of anti-TNF agents impacts the need for early surgery in Crohn's disease (CD) and ulcerative colitis (UC). METHODS Retrospective, cohort study of patients diagnosed within a 6-year period before and after the licensing of anti-TNFs (1990-