{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:29:25Z","timestamp":1790166565714,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:00:00Z","timestamp":1704412800000},"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":[[2024,11,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The natural history of Crohn\u2019s disease (CD) can result in complications requiring surgery. Pediatric data are scarce about major abdominal surgery. The IBD Registry from the Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition has been active since 2008 and collects data from major pediatric IBD centers in Italy. The aim of the present report was to explore the prevalence of major abdominal surgery among children affected by CD in an era when antitumor necrosis factor (anti-TNF-\u03b1) agents were already used so that we might appraise the incidence of surgical-related complications and identify the factors associated with postoperative disease recurrence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively analyzed data from patients enrolled in the registry from January 2009 to December 2018. Patients with monogenic IBD and patients undergoing surgery for perianal disease were excluded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 135 of 1245 patients were identified. We report the prevalence of major abdominal surgery of 10.8%. Pediatric surgeons performed the procedure in 54.1% of cases, and a laparoscopic approach was used in 47.4% of surgical procedures. Seventeen patients (12.6%) experienced a total of 21 early postoperative complications, none of which was severe. A laparoscopic approach was the only factor negatively associated with the occurrence of postoperative complications (odds ratio, 0.22; 95% confidence interval, 0.06-0.8; P\u2005=\u2005.02). Fifty-four (40%) patients experienced postoperative endoscopic recurrence, and 33 (24.4%) of them experienced postoperative clinical recurrence. The postoperative treatment with anti-TNF-\u03b1 drugs was significantly associated with a reduced risk of endoscopic recurrence (odds ratio, 0.19; 95% confidence interval, 0.05-0.79; P\u2005=\u2005.02).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In our cohort, the overall prevalence of major abdominal surgery was low, as well as the rate of surgical-related complications. Postoperative anti-TNF-\u03b1 therapy seems be protective against endoscopic recurrence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izad310","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T17:41:58Z","timestamp":1704476518000},"page":"2087-2096","source":"Crossref","is-referenced-by-count":6,"title":["Major Abdominal Surgery for Pediatric Crohn\u2019s Disease in the Anti-TNF Era: 10-Year Analysis of Data From the IBD Registry of Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2770-1379","authenticated-orcid":false,"given":"Patrizia","family":"Alvisi","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology Unit, Pediatric Department, Maggiore C.A. Pizzardi Hospital , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Faraci","sequence":"additional","affiliation":[{"name":"Digestive Diseases Unit, Bambino Ges\u00f9 Children\u2019s Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Scarallo","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Nutrition Unit, Meyer Children\u2019s Hospital , Florence ,","place":["Italy"]},{"name":"Department NEUROFARBA, University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Congiu","sequence":"additional","affiliation":[{"name":"Residency School of Pediatrics, University of Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5249-8248","authenticated-orcid":false,"given":"Matteo","family":"Bramuzzo","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, IRCSS Burlo Garofolo , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Illiceto","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Endoscopy Unit, S Spirito Hospital , Pescara ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Arrigo","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Endoscopy Unit, IRCCS G. Gaslini Children\u2019s Hospital , Genoa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Romano","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood G. Barresi, University of Messina , Messina ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Zuin","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Fondazione IRCCS San Gerardo dei Tintori Hospital , Monza ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erasmo","family":"Miele","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Gatti","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, IRCSS Burlo Garofolo , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Aloi","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Renzo","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Nutrition Unit, Meyer Children\u2019s Hospital , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Caldaro","sequence":"additional","affiliation":[{"name":"Digestive Diseases Unit, Bambino Ges\u00f9 Children\u2019s Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"Labriola","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit, Pediatric Department, Maggiore C.A. 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