{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:16:50Z","timestamp":1788337010625,"version":"build-2803163510"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>No consensus exists on optimal strategy to prevent postoperative recurrence [POR] after ileocaecal resection [ICR] for Crohn\u2019s disease [CD]. We compared early medical prophylaxis versus expectant management with treatment driven by findings at elective endoscopy 6\u201312 months after ICR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective, multicentric, observational study was performed. CD patients undergoing first ICR were assigned to Cohort 1 if a biologic or immunomodulator was [re]started prophylactically after ICR, or to Cohort 2 if no postoperative prophylaxis was given and treatment was started as reaction to elective endoscopic findings. Primary endpoint was rate of endoscopic POR [Rutgeerts &amp;gt;i1]. Secondary endpoints were severe endoscopic POR [Rutgeerts i3\/i4], clinical POR, surgical POR, and treatment burden during follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 346 included patients, 47.4% received prophylactic postoperative treatment [proactive\/Cohort 1] and 52.6% did not [reactive\/Cohort 2]. Endoscopic POR [Rutgeerts\u2005&amp;gt;i1] rate was significantly higher in Cohort 2 [41.5% vs 53.8%, OR 1.81, p\u2005=\u20050.039] at endoscopy 6\u201312 months after surgery. No significant difference in severe endoscopic POR was found [OR 1.29, p\u2005=\u20050.517]. Cohort 2 had significantly higher clinical POR rates [17.7% vs 35.7%, OR 3.05, p\u2005=\u20050.002] and numerically higher surgical recurrence rates [6.7% vs 13.2%, OR 2.59, p\u2005=\u20050.051]. Cox proportional hazards regression analysis showed no significant difference in time to surgical POR of proactive versus expectant\/reactive approach [HR 2.50, p\u2005=\u20050.057]. Quasi-Poisson regression revealed a significantly lower treatment burden for immunomodulator use in Cohort 2 [mean ratio 0.53, p\u2005=\u20050.002], but no difference in burden of biologics or combination treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The PORCSE study showed lower rates of endoscopic POR with early postoperative medical treatment compared with expectant management after first ileocaecal resection for Crohn\u2019s disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjae011","type":"journal-article","created":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T12:57:50Z","timestamp":1705755470000},"page":"1202-1214","source":"Crossref","is-referenced-by-count":16,"title":["Prophylactic Versus Endoscopy-driven Treatment of Crohn\u2019s Postoperative Recurrence: A Retrospective, Multicentric, European Study [PORCSE Study]"],"prefix":"10.1093","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0126-2929","authenticated-orcid":false,"given":"Jeroen","family":"Geldof","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Ghent , Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Truyens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Ghent , Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Hanssens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Ghent , Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Van Gucht","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Ghent , Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Holvoet","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, VITAZ , Sint-Niklaas , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ainara","family":"Elorza","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Universitario de Galdakao, Biocruces Bizkaia Health Research Institute , Vizcaya , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Bouillon","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Erasme University Hospital , Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f3nia","family":"Barros","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology \u2013 Algarve Universitary Medical Center , Lisbon , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviana","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology \u2013 Algarve Universitary Medical Center , Lisbon , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Argyriou","sequence":"additional","affiliation":[{"name":"University Hospital of Larissa - IBD unit, Department of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Thessaly , Larisa , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spyridon","family":"Potamianos","sequence":"additional","affiliation":[{"name":"University Hospital of Larissa - IBD unit, Department of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Thessaly , Larisa , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mircea","family":"Diculescu","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Center Fundeni Clinical Institute, Carol Davila University of Medicine Bucharest , Bucharest , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tudor","family":"Stroie","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Center Fundeni Clinical Institute, Carol Davila University of Medicine Bucharest , Bucharest , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4027-7365","authenticated-orcid":false,"given":"Peter","family":"Bossuyt","sequence":"additional","affiliation":[{"name":"Imelda GI Clinical Research Center, Department of Gastroenterology, Imelda General Hospital , Bonheiden , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annick","family":"Moens","sequence":"additional","affiliation":[{"name":"Imelda GI Clinical Research Center, Department of Gastroenterology, Imelda General Hospital , Bonheiden , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirini","family":"Theodoraki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital Heraklion , Heraklion , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis E","family":"Koutroubakis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital Heraklion , Heraklion , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Pedro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Hospital Santa Maria, Centro Hospital Universitario de Liboa Norte , Lisbon , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Hospital Santa Maria, Centro Hospital Universitario de Liboa Norte , Lisbon , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinelopi","family":"Nikolaou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Venizeleio General Hospital , Heraklion , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Karmiris","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Venizeleio General Hospital , Heraklion , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip J","family":"Baert","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, AZ Delta , Roeselare , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0469-4332","authenticated-orcid":false,"given":"Rocio","family":"Ferreiro-Iglesias","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Diseases Unit, Department of Gastroenterology, Hospital Clinico Universitario de Santiago, Fundaci\u00f3n Instituto de investigaci\u00f3n Sanitaria de Santiago de Compostela, Santiago de Compostela , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Peeters","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, AZ Sint-Lucas , Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Claeys","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, AZ Sint-Lucas , Ghent , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jos\u00e9","family":"Casanova","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa [IIS-Princesa], Universidad Aut\u00f3noma de Madrid [UAM], Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas [CIBEREHD] , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Eder","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences , Poznan , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross J","family":"Porter","sequence":"additional","affiliation":[{"name":"Edinburgh IBD unit, Western General Hospital , Edinburgh , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Arnott","sequence":"additional","affiliation":[{"name":"Edinburgh IBD unit, Western General Hospital , Edinburgh , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarkan","family":"Karakan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Gazi University , Ankara , Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7864-8187","authenticated-orcid":false,"given":"Francisco","family":"Mesonero","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Rev\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Beatriz \u00c2ngelo , Loures , Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evi","family":"Van Dyck","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, AZ Klina , Brasschaat , 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Hepatol","author":"Tsai","year":"2021"},{"key":"2024082420321800400_CIT0004","first-page":"665","article-title":"Natural history of recurrent Crohn\u2019s disease at the ileocolonic anastomosis after curative surgery","volume-title":"Gut","author":"Rutgeerts","year":"1984"},{"key":"2024082420321800400_CIT0005","first-page":"956","article-title":"Predictability of the postoperative course of Crohn\u2019s disease","volume-title":"Gastroenterology","author":"Rutgeerts","year":"1990"},{"key":"2024082420321800400_CIT0006","first-page":"1213","article-title":"The effect of smoking after surgery for Crohn\u2019s disease: a meta-analysis of observational studies","volume-title":"Int J Colorectal Dis","author":"Reese","year":"2008"},{"key":"2024082420321800400_CIT0007","first-page":"758","article-title":"Postoperative recurrent luminal Crohn\u02bcs Disease: a systematic review","volume-title":"Inflamm Bowel Dis","author":"De Cruz","year":"2012"},{"key":"2024082420321800400_CIT0008","first-page":"545","article-title":"Meta-analysis: factors predicting post-operative recurrence with placebo therapy in patients with Crohn\u2019s disease","volume-title":"Aliment Pharmacol Ther","author":"Pascua","year":"2008"},{"key":"2024082420321800400_CIT0009","first-page":"177","article-title":"Meta-analysis of the role of granulomas in the recurrence of Crohn disease","volume-title":"Dis Colon Rectum","author":"Simillis","year":"2010"},{"key":"2024082420321800400_CIT0010","first-page":"167","article-title":"Analysis of risk factors, especially different types of plexitis, for postoperative relapse in Crohn\u2019s disease","volume-title":"World J Gastrointest Surg","author":"Milassin","year":"2017"},{"key":"2024082420321800400_CIT0011","first-page":"462","article-title":"Prominence of ileal mucosa-associated microbiota to predict postoperative endoscopic recurrence in Crohn\u2019s disease","volume-title":"Gut","author":"Sokol","year":"2020"},{"key":"2024082420321800400_CIT0012","doi-asserted-by":"crossref","first-page":"s1","DOI":"10.1136\/gutjnl-2019-318484","article-title":"British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults","volume":"68","author":"Lamb","year":"2019","journal-title":"Gut"},{"key":"2024082420321800400_CIT0013","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1093\/ecco-jcc\/jjz187","article-title":"ECCO guidelines on therapeutics in Crohn\u2019s disease: surgical treatment","volume":"14","author":"Adamina","year":"2020","journal-title":"J Crohns Colitis"},{"key":"2024082420321800400_CIT0014","first-page":"191","article-title":"Microbial factors associated with postoperative Crohn\u2019s disease recurrence","volume-title":"J Crohns Colitis","author":"Wright","year":"2017"},{"key":"2024082420321800400_CIT0015","first-page":"221","article-title":"Prophylactic medication for the prevention of endoscopic recurrence in Crohn\u2019s disease: a prospective study based on clinical risk stratification","volume-title":"J Crohns Colitis","author":"Arkenbosch","year":"2023"},{"key":"2024082420321800400_CIT0016","first-page":"1062","article-title":"The prevention and management of Crohn\u2019s disease postoperative recurrence: results from the Y-ECCO\/ClinCom 2019 Survey","volume-title":"Eur J Gastroenterol Hepatol","author":"Dragoni","year":"2020"},{"key":"2024082420321800400_CIT0017","first-page":"617","article-title":"Systematic versus endoscopy-driven treatment with azathioprine to prevent postoperative ileal Crohn\u2019s disease recurrence","volume-title":"J Crohns Colitis","author":"Ferrante","year":"2015"},{"key":"2024082420321800400_CIT0018","first-page":"1084","article-title":"Postoperative endoscopic recurrence on the neoterminal ileum but not on the anastomosis is mainly driving long-term outcomes in Crohn\u2019s disease","volume-title":"Am J Gastroenterol","author":"Hammoudi","year":"2020"},{"key":"2024082420321800400_CIT0019","first-page":"269","article-title":"Differential risk of disease progression between isolated anastomotic ulcers and mild ileal recurrence after ileocolonic resection in patients with Crohn\u2019s disease","volume-title":"Gastrointest Endosc","author":"Ollech","year":"2019"},{"key":"2024082420321800400_CIT0020","first-page":"1406","article-title":"Crohn\u2019s disease management after intestinal resection: a randomised trial","volume-title":"Lancet","author":"De Cruz","year":"2015"},{"key":"2024082420321800400_CIT0021","first-page":"72","article-title":"Immediate versus tailored prophylaxis to prevent symptomatic recurrences after surgery for ileocaecal Crohn\u2019s disease","volume-title":"Surgery","author":"Bordeianou","year":"2011"},{"key":"2024082420321800400_CIT0022","first-page":"1930","article-title":"Cost\u2013utility analysis","volume-title":"Inflamm Bowel Dis","author":"Candia","year":"2017"},{"key":"2024082420321800400_CIT0023","first-page":"O267","article-title":"Immediate prophylactic vs endoscopic or symptomatic-driven azathioprine treatment to prevent surgical recurrence after intestinal resection for Crohn\u2019s disease","volume-title":"Colorectal Dis","author":"Guo","year":"2018"},{"key":"2024082420321800400_CIT0024","first-page":"S373","article-title":"P354 Early treatment versus active surveillance after ileocolic resection in Crohn\u2019s disease: a retrospective cohort study","volume-title":"J Crohns Colitis","author":"Haenen","year":"2021"},{"key":"2024082420321800400_CIT0025","first-page":"13549","article-title":"Third European evidence-based consensus on the diagnosis and management of Crohn\u2019s disease 2016: part 2: surgical management and special situations","volume-title":"J Crohns Colitis","author":"Gionchetti","year":"2017"},{"key":"2024082420321800400_CIT0026","first-page":"271","article-title":"American Gastroenterological Association Institute Guideline on the Management of Crohn\u2019s disease after surgical resection","volume-title":"Gastroenterology","author":"Nguyen","year":"2017"},{"key":"2024082420321800400_CIT0027","first-page":"6746","article-title":"Contemporary management of postoperative Crohn\u2019s disease after ileocolonic resection","volume-title":"J Clin Med","author":"Hanzel","year":"2022"},{"key":"2024082420321800400_CIT0028","first-page":"508","article-title":"Impact of azathioprine on the prevention of postoperative Crohn\u02bcs disease recurrence: Results of a prospective, observational, long-term follow-up study","volume-title":"Inflamm Bowel Dis","author":"Dom\u00e8nech","year":"2008"},{"key":"2024082420321800400_CIT0029","first-page":"2139","article-title":"Reliability of endoscopic evaluation of postoperative recurrent Crohn\u2019s disease","volume-title":"Clin Gastroenterol Hepatol","author":"Ma","year":"2020"},{"key":"2024082420321800400_CIT0030","first-page":"271","article-title":"Comparison of two strategies for the management of postoperative recurrence in Crohn\u2019s disease patients with one clinical risk factor: a multicentre IG-IBD study","volume-title":"United Eur Gastroenterol J","author":"Dragoni","year":"2023"},{"key":"2024082420321800400_CIT0031","first-page":"3508","article-title":"What\u2019s new in the postoperative management of Crohn\u2019s disease","volume-title":"Dig Dis Sci","author":"Dasharathy","year":"2022"},{"key":"2024082420321800400_CIT0032","first-page":"1643","article-title":"No change in determining Crohn\u2019s disease recurrence or need for endoscopic or surgical intervention with modification of the Rutgeerts\u2019 scoring system","volume-title":"Clin Gastroenterol Hepatol","author":"Rivi\u00e8re","year":"2019"},{"key":"2024082420321800400_CIT0033","first-page":"1","article-title":"ECCO-ESCP consensus on surgery for Crohn\u2019s disease","volume-title":"J Crohns Colitis","author":"Bemelman","year":"2017"},{"key":"2024082420321800400_CIT0034","first-page":"1201","article-title":"Postoperative Crohn\u2019s disease recurrence: time to adapt endoscopic recurrence scores to the leading surgical techniques","volume-title":"Clin Gastroenterol Hepatol","author":"Rivi\u00e8re","year":"2022"},{"key":"2024082420321800400_CIT0035","first-page":"e00218","article-title":"Antitumor necrosis factor agents to treat endoscopic postoperative recurrence of Crohn\u2019s disease: a nationwide study with propensity-matched score analysis","volume-title":"Clin Transl Gastroenterol","author":"Ca\u00f1ete","year":"2020"},{"key":"2024082420321800400_CIT0036","first-page":"1293","article-title":"Adalimumab vs azathioprine in the prevention of postoperative Crohn\u2019s disease recurrence. A GETECCU randomised trial","volume-title":"J Crohns Colitis","author":"L\u00f3pez-Sanrom\u00e1n","year":"2017"},{"key":"2024082420321800400_CIT0037","first-page":"267","article-title":"Editorial: Postoperative management of Crohn\u2019s disease: one size does not fit all","volume-title":"United Eur Gastroenterol J","author":"Dom\u00e8nech","year":"2023"},{"key":"2024082420321800400_CIT0038","doi-asserted-by":"crossref","article-title":"Prevention of postoperative recurrence of Crohn\u2019s disease with vedolizumab: first results of the prospective placebo-controlled randomized trial REPREVIO","author":"D\u2019Haens","DOI":"10.1093\/ecco-jcc\/jjac190.0014"}],"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\/jjae011\/56594583\/jjae011.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article-pdf\/18\/8\/1202\/58913314\/jjae011.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article-pdf\/18\/8\/1202\/58913314\/jjae011.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,24]],"date-time":"2024-08-24T20:32:50Z","timestamp":1724531570000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article\/18\/8\/1202\/7578736"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,19]]},"references-count":38,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,1,19]]},"published-print":{"date-parts":[[2024,8,14]]}},"URL":"https:\/\/doi.org\/10.1093\/ecco-jcc\/jjae011","relation":{},"ISSN":["1873-9946","1876-4479"],"issn-type":[{"value":"1873-9946","type":"print"},{"value":"1876-4479","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,8]]},"published":{"date-parts":[[2024,1,19]]}}}