Inflammatory bowel diseases · 2026
Incidence and predictors of surgical recurrence after primary ileocolic resection in Crohn ileitis: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Haanappel Anouck E G, van der Does de Willebois Eline M L, Ali Mahsoem, Jamaludin Faridi S, Duijvestein Marjolijn, Buskens Christianne J, Bemelman Willem A, de Groof E Joline
Аннотация
INTRODUCTION: Treatment strategies for Crohn disease (CD) have evolved considerably over recent decades. Approximately 65% of primary resections for CD comprise ileocolic resections (ICR). Currently, up-to-date data are not available on surgical recurrence risk after primary ICR, as previous meta-analyses combined various types of intestinal resections. As such, we aimed to assess the incidence, predictors, and trends of surgical recurrence after primary ICR for CD.
METHODS: MEDLINE, EMBASE, and the Cochrane database were searched from inception until November 15, 2023. Studies were included if they described the surgical recurrence risk after a primary ICR for CD. The primary endpoint was surgical recurrence, defined as reoperation due to disease recurrence in the neoterminal ileum. Meta-analyses were performed to (1) evaluate trends in surgical recurrence over time, (2) estimate the risk of surgical recurrence in the biologics era (post-2000), and (3) identify risk factors for surgical recurrence.
RESULTS: Among 3498 articles screened, 55 were included, of which 31 studies reported cumulative 5- and/or 10-year surgical recurrence rates (study inclusion period: 1932-2020; n = 28 354 patients). Meta-regression analysis indicated a declining trend in both 5- and 10-year surgical recurrence rates, which stabilized after 2000. In the biologics era, pooled 5- and 10-year surgical recurrence risks were 5.7% (95% CI, 3.9-8.4) and 13.0% (8.3-19.7), respectively. Smoking, patient sex, perianal disease, and behavior were not significantly prognostic for surgical recurrence after primary ICR.
CONCLUSION: Approximately 1 in 17 patients experience surgical recurrence within 5 years after primary ICR. The risk of surgical recurrence decreased over the past decades but has stabilized in the biologics era.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No. CRD42020213027.
METHODS: MEDLINE, EMBASE, and the Cochrane database were searched from inception until November 15, 2023. Studies were included if they described the surgical recurrence risk after a primary ICR for CD. The primary endpoint was surgical recurrence, defined as reoperation due to disease recurrence in the neoterminal ileum. Meta-analyses were performed to (1) evaluate trends in surgical recurrence over time, (2) estimate the risk of surgical recurrence in the biologics era (post-2000), and (3) identify risk factors for surgical recurrence.
RESULTS: Among 3498 articles screened, 55 were included, of which 31 studies reported cumulative 5- and/or 10-year surgical recurrence rates (study inclusion period: 1932-2020; n = 28 354 patients). Meta-regression analysis indicated a declining trend in both 5- and 10-year surgical recurrence rates, which stabilized after 2000. In the biologics era, pooled 5- and 10-year surgical recurrence risks were 5.7% (95% CI, 3.9-8.4) and 13.0% (8.3-19.7), respectively. Smoking, patient sex, perianal disease, and behavior were not significantly prognostic for surgical recurrence after primary ICR.
CONCLUSION: Approximately 1 in 17 patients experience surgical recurrence within 5 years after primary ICR. The risk of surgical recurrence decreased over the past decades but has stabilized in the biologics era.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No. CRD42020213027.