{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:28:44Z","timestamp":1790832524151,"version":"4.1.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes, Digestive and Kidney Diseases","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5U01DK062423"],"award-info":[{"award-number":["5U01DK062423"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The clinical relevance and underlying mechanism of isolated anastomotic ulcers (IAUs) following ileocolic resection (ICR) in patients with Crohn\u2019s disease (CD) are poorly understood. This study aimed to assess the postoperative recurrence (POR) risk and the mucosa-associated microbiome composition in CD patients with or without IAUs among those with a healthy neo-terminal ileum (TI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CD patients who underwent ICR and without any ulcerations in the neo-TI (SES-CD \u22642) at first postoperative ileocolonoscopy were identified from an ongoing prospective multicenter study. The primary study outcome was time to POR measured from the first postoperative ileocolonoscopy. Cox proportional hazard models were used to assess the association of IAUs with time to POR. The mucosa-associated microbiome at first ileocolonoscopy was assessed by sequencing the 16S rRNA gene using biopsies taken from both sides of the anastomosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty patients were included, of whom 27 patients had IAUs (45.0%) at first ileocolonoscopy. Median time to first postoperative ileocolonoscopy was 6.5 months (interquartile range [IQR] 5.3-8.1). During a median follow-up duration of 3.0 years (IQR 1.4-5.5) after first postoperative ileocolonoscopy, POR was observed in 53.3%. After adjustment for clinical risk factors, IAUs were independently associated with POR (adjusted hazard ratios 5.4; 95% CI 2.4-12.4; P\u2005&amp;lt;\u2005.001). At the ileal and colonic side of the anastomosis, a significantly higher abundance of Klebsiella was associated with IAUs (q\u2005&amp;lt;\u20050.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IAUs in CD patients with otherwise healthy neo-TI at first postoperative ileocolonoscopy are associated with long-term POR. In addition, a differential mucosa-associated microbiome composition was observed in patients with IAUs, specifically the proteobacteria Klebsiella, suggesting that putative taxa are related to these lesions. Further validation studies in larger cohorts, along with mechanistic studies, are still required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izaf147","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T09:06:32Z","timestamp":1752656792000},"page":"3247-3255","source":"Crossref","is-referenced-by-count":4,"title":["Isolated Anastomotic Ulcers Are Associated with a Higher Long-Term Risk for Postoperative Recurrence and a Differential Mucosa-Associated Microbiome Composition in Patients with Crohn\u2019s Disease Following Ileocolic Resection"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8515-425X","authenticated-orcid":false,"given":"Michiel Thomas Jan","family":"Bak","sequence":"first","affiliation":[{"name":"Zane Cohen Centre for Digestive Diseases, Lunenfeld-Tanenbaum Research Institute, Sinai Health System , 60 Murray St, Toronto, ON M5T 3L9 ,","place":["Canada"]},{"name":"Division of 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Lunenfeld-Tanenbaum Research Institute, Sinai Health System , 60 Murray St, Toronto, ON M5T 3L9 ,","place":["Canada"]},{"name":"Division of Gastroenterology, Mount Sinai Hospital, Sinai Health System, University of Toronto , 600 University Ave, Toronto, ON M5G 1X5 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Borowski","sequence":"additional","affiliation":[{"name":"Zane Cohen Centre for Digestive Diseases, Lunenfeld-Tanenbaum Research Institute, Sinai Health System , 60 Murray St, Toronto, ON M5T 3L9 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9364-5868","authenticated-orcid":false,"given":"Williams","family":"Turpin","sequence":"additional","affiliation":[{"name":"Zane Cohen Centre for Digestive Diseases, Lunenfeld-Tanenbaum Research Institute, Sinai Health System , 60 Murray St, Toronto, ON M5T 3L9 ,","place":["Canada"]},{"name":"Division of Gastroenterology, Mount Sinai Hospital, Sinai Health System, University of Toronto , 600 University Ave, Toronto, ON M5G 1X5 ,","place":["Canada"]},{"name":"Department of Nutritional Sciences Temerty Faculty of Medicine, University of Toronto , 1 King\u2019s College Cir, Toronto, ON M5S 3K3 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haim","family":"Leibovitzh","sequence":"additional","affiliation":[{"name":"Zane Cohen Centre for Digestive Diseases, Lunenfeld-Tanenbaum Research Institute, Sinai Health System , 60 Murray St, Toronto, ON M5T 3L9 ,","place":["Canada"]},{"name":"Division of Gastroenterology, Mount Sinai Hospital, Sinai Health System, University of Toronto , 600 University Ave, Toronto, ON M5G 1X5 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Milgrom","sequence":"additional","affiliation":[{"name":"Zane Cohen Centre for Digestive Diseases, Lunenfeld-Tanenbaum Research 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