{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:11:47Z","timestamp":1790089907742,"version":"4.0.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>Adequate endoscopic scoring in Crohn\u2019s disease [CD] is crucial, as it dictates the need for initiating postoperative medical therapy and is utilized as an outcome parameter in clinical trials. Here we aimed to observe anastomotic wound healing in relation to endoscopic scoring of both inverted and everted stapled lines in side-to-side anastomoses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Two prospective patient cohorts were included: ileocolic resection [ICR] for CD, and right-sided colon resection for colorectal cancer [CRC]. Videos taken during colonoscopy 6 months postoperatively were evaluated. The Simplified Endoscopic Activity Score for Crohn\u2019s Disease and modified Rutgeerts score were determined. The primary outcome was the presence of ulcerations in CD patients on both the inverted and the everted stapled lines. Secondary outcomes were the presence of anastomotic ulcerations in CRC patients and the number of cases having ulcerations exclusively at the inverted stapled line.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 82 patients included in the CD cohort, ulcerations were present in 63\/82 [76.8%] at the inverted- vs 1\/71 [1.4%] at the everted stapled line. Likewise in the CRC cohort, ulcerations were present in 4\/6 [67.7%] at the inverted vs 0\/6 [0%] at the everted stapled line. In total, 27% of the 63 patients in the CD cohort had ulcerations exclusively on the inverted stapled line.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Inverted stapled lines heal with ulcerations, whereas everted stapled lines heal without any ulcerations, in both CD and non-CD patients. The abnormalities at the inverted stapled line might interfere with endoscopic scoring of recurrence, with potentially an impact on patients\u2019 quality of life and on healthcare costs if postoperative treatment is initiated incorrectly.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjac175","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T09:19:39Z","timestamp":1668590379000},"page":"693-699","source":"Crossref","is-referenced-by-count":23,"title":["Endoscopic Recurrence or Anastomotic Wound Healing Phenomenon after Ileocolic Resection for Crohn\u2019s Disease: The Challenges of Accurate Endoscopic Scoring"],"prefix":"10.1093","volume":"17","author":[{"given":"Eline M L","family":"van der Does de Willebois","sequence":"first","affiliation":[{"name":"Department of Surgery, Amsterdam UMC, University of Amsterdam , Amsterdam , the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism , Amsterdam , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolijn","family":"Duijvestein","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam , Amsterdam , the Netherlands"},{"name":"Department of Gastroenterology, Radboudumc , Nijmegen , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin A","family":"Wasmann","sequence":"additional","affiliation":[{"name":"Department of Surgery, UMC Utrecht , Utrecht , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert R A M","family":"D\u2019Haens","sequence":"additional","affiliation":[{"name":"Amsterdam Gastroenterology Endocrinology Metabolism , Amsterdam , the Netherlands"},{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam , Amsterdam , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarmila D W","family":"van der Bilt","sequence":"additional","affiliation":[{"name":"Department of Surgery, Flevoziekenhuis , Almere , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco W","family":"Mundt","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Flevoziekenhuis , Almere , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roel","family":"Hompes","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC, University of Amsterdam , Amsterdam , the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism , Amsterdam , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"van der Vlugt","sequence":"additional","affiliation":[{"name":"Amsterdam Gastroenterology Endocrinology Metabolism , Amsterdam , the Netherlands"},{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam , Amsterdam , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christianne J","family":"Buskens","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC, University of Amsterdam , Amsterdam , the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism , Amsterdam , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem A","family":"Bemelman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC, University of Amsterdam , Amsterdam , the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism , Amsterdam , the Netherlands"},{"name":"Coloproctology and Inflammatory Bowel Disease Unit, HSR , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,11,16]]},"reference":[{"key":"2023050314423394200_CIT0001","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/0022-4804(67)90069-8","article-title":"Bowel anastomosis by inverting and everting techniques. An experimental study","volume":"7","author":"Healey","year":"1967","journal-title":"J Surg Res"},{"key":"2023050314423394200_CIT0002","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/BF01655019","article-title":"Studies in the healing of intestinal anastomoses","volume":"5","author":"Ravitch","year":"1981","journal-title":"World J Surg"},{"key":"2023050314423394200_CIT0003","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1159\/000018677","article-title":"A comparison of stapled and hand-sewn anastomoses in Crohn\u2019s disease","volume":"15","author":"Kusunoki","year":"1998","journal-title":"Dig Surg"},{"key":"2023050314423394200_CIT0004","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.asjsur.2013.07.008","article-title":"Anastomotic stability and wound healing of colorectal anastomoses sealed and sutured with a collagen fleece in a rat peritonitis model","volume":"37","author":"Holmer","year":"2014","journal-title":"Asian J Surg"},{"key":"2023050314423394200_CIT0005","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1007\/BF02049926","article-title":"Advantages of handsewn over stapled bowel anastomosis","volume":"34","author":"Dziki","year":"1991","journal-title":"Dis Colon Rectum"},{"key":"2023050314423394200_CIT0006","doi-asserted-by":"crossref","first-page":"100879","DOI":"10.1016\/j.scrs.2022.100879","article-title":"The science of anastomotic healing.","volume":"33","author":"Ryan","year":"2022","journal-title":"Semin Colon Rectal Surg"},{"key":"2023050314423394200_CIT0007","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1093\/ecco-jcc\/jjw169","article-title":"3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn\u2019s Disease 2016: Part 2: Surgical Management and Special Situations","volume":"11","author":"Gionchetti","year":"2017","journal-title":"J Crohns Colitis"},{"key":"2023050314423394200_CIT0008","doi-asserted-by":"crossref","first-page":"2139","DOI":"10.1016\/j.cgh.2019.08.046","article-title":"Reliability of endoscopic evaluation of postoperative recurrent Crohn\u2019s disease","volume":"18","author":"Ma","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"8","key":"2023050314423394200_CIT0009","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1016\/j.cgh.2020.05.037","article-title":"Dutch-Belgian The Effect of Vitamin D3 to Prevent Postoperative Relapse of Crohn\u2019s Disease: A Placebo-controlled Randomized Trial Study Group. High-Dose Vitamin D Does Not Prevent Postoperative Recurrence of Crohn\u2019s Disease in a Randomized Placebo-Controlled Trial.","volume":"19","author":"de Bruyn","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2023050314423394200_CIT0010","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/S0016-5107(04)01878-4","article-title":"Development and validation of a new, simplified endoscopic activity score for Crohn\u2019s disease: the SES-CD","volume":"60","author":"Daperno","year":"2004","journal-title":"Gastrointest Endosc"},{"key":"2023050314423394200_CIT0011","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/0016-5085(90)90613-6","article-title":"Predictability of the postoperative course of Crohn\u2019s disease","volume":"99","author":"Rutgeerts","year":"1990","journal-title":"Gastroenterology"},{"key":"2023050314423394200_CIT0012","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1016\/j.cgh.2022.02.025","article-title":"Postoperative Crohn\u2019s disease recurrence: time to adapt endoscopic recurrence scores to the leading surgical techniques","volume":"20","author":"Riviere","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2023050314423394200_CIT0013","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1093\/ibd\/izab259","article-title":"Recommendations for standardizing clinical trial design and endoscopic assessment in postoperative Crohn\u2019s disease","volume":"28","author":"Hanzel","year":"2022","journal-title":"Inflamm Bowel Dis"},{"key":"2023050314423394200_CIT0014","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1001\/2013.jamasurg.33","article-title":"Systematic review of the technique of colorectal anastomosis","volume":"148","author":"Slieker","year":"2013","journal-title":"JAMA Surg"},{"key":"2023050314423394200_CIT0015","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1093\/ecco-jcc\/jjw082","article-title":"Interobserver variation study of the Rutgeerts score to assess endoscopic recurrence after surgery for Crohn\u2019s disease","volume":"10","author":"Marteau","year":"2016","journal-title":"J Crohns Colitis"},{"key":"2023050314423394200_CIT0016","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1007\/s11605-015-3061-3","article-title":"Kono-S anastomosis for surgical prophylaxis of anastomotic recurrence in Crohn\u2019s disease: an international multicenter study","volume":"20","author":"Kono","year":"2016","journal-title":"J Gastrointest Surg"},{"key":"2023050314423394200_CIT0017","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/SLA.0000000000003936","article-title":"Surgical prophylaxis of Crohn disease recurrence: \u2018light at the end of the tunnel\u2019","volume":"272","author":"Kono","year":"2020","journal-title":"Ann Surg"},{"key":"2023050314423394200_CIT0018","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/SLA.0000000000003821","article-title":"Surgical prevention of anastomotic recurrence by excluding mesentery in Crohn\u2019s disease: The SuPREMe-CD study - a randomized clinical trial","volume":"272","author":"Luglio","year":"2020","journal-title":"Ann Surg"},{"issue":"5","key":"2023050314423394200_CIT0019","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/DCR.0b013e3181a4fa58","article-title":"Investigators of the CAST Trial. Recurrence of Crohn's disease after ileocolic resection is not affected by anastomotic type: results of a multicenter, randomized, controlled trial.","volume":"52","author":"McLeod","year":"2009","journal-title":"Dis Colon Rectum"},{"key":"2023050314423394200_CIT0020","doi-asserted-by":"crossref","first-page":"979","DOI":"10.2174\/1389201019666180216152805","article-title":"Postoperative recurrence of Crohn\u2019s disease: pathophysiology, diagnosis and treatment","volume":"18","author":"Di Sario","year":"2017","journal-title":"Curr Pharm Biotechnol"},{"key":"2023050314423394200_CIT0021","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1038\/s41586-019-1237-9","article-title":"Multi-omics of the gut microbial ecosystem in inflammatory bowel diseases","volume":"569","author":"Lloyd-Price","year":"2019","journal-title":"Nature"},{"key":"2023050314423394200_CIT0022","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1038\/s41575-019-0248-1","article-title":"Host\u2013microbiota interactions in inflammatory bowel disease","volume":"17","author":"Neurath","year":"2020","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2023050314423394200_CIT0023","doi-asserted-by":"crossref","first-page":"615858","DOI":"10.3389\/fmed.2020.615858","article-title":"Gut microbiota profiles and microbial-based therapies in post-operative Crohn\u2019s disease: a systematic review","volume":"7","author":"Zhuang","year":"2020","journal-title":"Front Med [Lausanne]"},{"key":"2023050314423394200_CIT0024","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1016\/0016-5085(95)90121-3","article-title":"Controlled trial of metronidazole treatment for prevention of Crohn\u2019s recurrence after ileal resection","volume":"108","author":"Rutgeerts","year":"1995","journal-title":"Gastroenterology"},{"key":"2023050314423394200_CIT0025","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1093\/ecco-jcc\/jjz047","article-title":"Low-dose metronidazole is associated with a decreased rate of endoscopic recurrence of Crohn\u2019s disease after ileal resection: a retrospective cohort study","volume":"13","author":"Glick","year":"2019","journal-title":"J Crohns Colitis"},{"key":"2023050314423394200_CIT0026","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s40265-020-01266-3","article-title":"Pharmacological prevention of postoperative recurrence in Crohn\u2019s disease","volume":"80","author":"Vuitton","year":"2020","journal-title":"Drugs"},{"key":"2023050314423394200_CIT0027","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/2049-2618-2-35","article-title":"Intestinal anastomotic injury alters spatially defined microbiome composition and function","volume":"2","author":"Shogan","year":"2014","journal-title":"Microbiome"}],"container-title":["Journal of Crohn's and Colitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/advance-article-pdf\/doi\/10.1093\/ecco-jcc\/jjac175\/48744817\/jjac175.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article-pdf\/17\/5\/693\/50188061\/jjac175.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article-pdf\/17\/5\/693\/50188061\/jjac175.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T15:17:26Z","timestamp":1683127046000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article\/17\/5\/693\/6830740"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,16]]},"references-count":27,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,11,16]]},"published-print":{"date-parts":[[2023,5,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ecco-jcc\/jjac175","relation":{},"ISSN":["1873-9946","1876-4479"],"issn-type":[{"value":"1873-9946","type":"print"},{"value":"1876-4479","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,5,1]]},"published":{"date-parts":[[2022,11,16]]}}}