{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:04:00Z","timestamp":1784761440037,"version":"3.55.0"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die Colitis ulcerosa ist eine chronisch-entz\u00fcndliche Systemerkrankung mit steigender Inzidenz und hoher Morbidit\u00e4t. Trotz etablierter Therapiestrategien, insbesondere der Rezidivprophylaxe mit Mesalazin, erleiden innerhalb eines Jahres etwa ein Drittel der Patientinnen und Patienten ein Rezidiv. Epidemiologische Studien zeigen eine inverse Assoziation zwischen vorausgegangener Appendektomie und Erkrankungsrisiko, was auf eine immunologische Rolle des Appendix hinweist. Vor diesem Hintergrund wurde die Appendektomie als ein potenziell krankheitsmodifizierender Ansatz postuliert. Die randomisierte ACCURE-Studie belegt im Remissionserhalt eine signifikante Reduktion der Ein-Jahres-Rezidivrate durch zus\u00e4tzliche Appendektomie (36% vs. 56%; relatives Risiko 0,65; NNT=5) bei g\u00fcnstiger Sicherheitsbilanz. F\u00fcr aktive Erkrankungen unter fortgeschrittener Therapie zeigte die nicht-randomisierte COSTA-Studie h\u00f6here steroidfreie Remissionsraten nach Appendektomie im Vergleich zu einem Wechsel auf JAK-Inhibitoren, jedoch ohne Unterschied hinsichtlich Kolektomierate. In der PASSION-Studie bei therapierefrakt\u00e4ren Verl\u00e4ufen erreichten 30% ein klinisches Ansprechen; ein histologisch entz\u00fcndeter Appendix war pr\u00e4diktiv f\u00fcr Therapieerfolg. Zusammenfassend existiert randomisierte Evidenz ausschlie\u00dflich f\u00fcr das Remissionserhaltungs-Setting. Die Appendektomie erscheint als risikoarmer, potenziell additiver Ansatz f\u00fcr selektionierte Patientinnen und Patienten, bedarf jedoch weiterer kontrollierter Studien mit Langzeitbeobachtung und Biomarkerstratifizierung.<\/jats:p>","DOI":"10.1055\/a-2871-3663","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:02:58Z","timestamp":1780095778000},"page":"920-925","source":"Crossref","is-referenced-by-count":0,"title":["Die Appendektomie als krankheitsmodifizierende Therapie bei Colitis ulcerosa?"],"prefix":"10.1055","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6101-5244","authenticated-orcid":false,"given":"Andreas","family":"Stallmach","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Jena, Thuringia, Germany","place":["Jena"],"department":["Klinik f\u00fcr Innere Medizin IV (Gastroenterologie, Hepatologie Infektiologie)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Kolleck","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Jena, Thuringia, Germany","place":["Jena"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1097\/MIB.0b013e31827f27ae","article-title":"Crohn\u2019s disease and ulcerative colitis are associated with elevated standardized mortality ratios: a meta-analysis","volume":"19","author":"M Bewtra","year":"2013","journal-title":"Inflammatory bowel diseases"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32126-2","article-title":"Ulcerative colitis","author":"R Ungaro","year":"2016","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1097\/MEG.0b013e3282f97b33","article-title":"The 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