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We aimed to evaluate the impact of extended vs. limited mesenteric excisions on intra- and postoperative outcomes in patients undergoing primary ileocolic resection for CD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted in PubMed, EMBASE, Web of Science, ClinicalTrials.gov, and ISRCTN up to February 2025. Randomized controlled trials (RCTs), non-RCTs, and retrospective studies comparing extended and limited mesenteric excision in primary ileocolic resections for CD were included. The primary outcome was endoscopic CD recurrence (Rutgeerts score\u2009\u2265\u2009i2). Secondary outcomes included severe endoscopic recurrence (\u2265\u2009i2b or\u2009\u2265\u2009i3), surgical recurrence, anastomotic leaks, operative time, conversion to open surgery, severe postoperative complications, and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over the 2588 records initially screened, 4 studies were included, involving a total of 632 patients. Pooled analysis showed no significant difference in endoscopic recurrence rates between extended and limited resections (48.2% vs. 54.1%; RR: 0.91; 95% CI: 0.70\u20131.18; p\u2009=\u20090.46; I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200957%). Additionally, there were no significant differences in the risk of anastomotic leak (3.8% vs. 2.6%; RR: 1.35; 95% CI: 0.14\u201312.88; p\u2009=\u20090.80; I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200952%) or any other analyzed outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Extended mesenteric excision does not appear to significantly reduce endoscopic recurrence compared with limited excision in primary ileocolic resections for CD. Until further high-quality evidence is available, surgical teams should adhere to their established practice and refrain from implementing extended resections outside well-designed prospective studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>PROSPERO (CRD42025644791).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00384-025-05043-0","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T15:06:54Z","timestamp":1764688014000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of extensive mesenteric excision on primary ileocolic resection outcomes in Crohn\u2019s disease patients: a systematic review with meta-analysis"],"prefix":"10.1007","volume":"40","author":[{"given":"Aleix","family":"Mart\u00ednez-P\u00e9rez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo Alberto","family":"Schena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Pellino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"El\u00edas","family":"Mart\u00ednez-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danila","family":"Azzolina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"de\u2019Angelis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"5043_CR1","doi-asserted-by":"publisher","first-page":"2769","DOI":"10.1016\/S0140-6736(17)32448-0","volume":"390","author":"SC Ng","year":"2017","unstructured":"Ng SC, Shi HY, Hamidi N, Underwood FE, Tang W, Benchimol EI, Panaccione R, Ghosh S, Wu JCY, Chan FKL et al (2017) Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. 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