{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:26:43Z","timestamp":1790360803926,"version":"4.1.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,12,27]],"date-time":"2019-12-27T00:00:00Z","timestamp":1577404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Resections for Crohn\u2019s disease should be limited and only resect macroscopically affected bowel. However, recent studies suggest microscopic inflammation at resection margins as a predictor for postoperative recurrence. The clinical impact remains unclear, as non-uniform pathological criteria have been used. The aim of this study was to assess the predictive value of pathological characteristics at ileocecal resection margins for recurrence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Both resection margins of 106 consecutive patients undergoing ileocecal resection for Crohn\u2019s disease between 2002 and 2009 were revised and scored for active inflammation, myenteric plexitis, and granulomas. Pathological findings were correlated to recurrence, defined as recurrent disease activity demonstrated by endoscopy (modified Rutgeerts score \u2265i2) requiring upscaling medical treatment, using multivariate analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Active inflammation was found at the proximal and distal resection margin in 27% and 15% of patients, respectively, myenteric plexitis in 37% and 32%, respectively, and granulomas in 4% and 6%, respectively. In total, 47 out of 106 patients developed recurrence. Only active inflammation at the distal colonic resection margin was an independent significant predictor for recurrence (88% vs 43% vs 51% for distal, proximal, and no involved margins, respectively; P &amp;lt; 0.01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Active inflammation at the distal colonic resection margin after ileocecal resection identifies a patient group at high risk for postoperative recurrence both at the anastomotic site and the colon because it identifies undiagnosed L3 disease. These patients have a different and more aggressive natural history and require more intense medical treatment. Therefore, pathological evaluation of the distal resection margin should be implemented in daily practice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izz290","type":"journal-article","created":{"date-parts":[[2019,12,27]],"date-time":"2019-12-27T07:27:44Z","timestamp":1577431664000},"page":"1691-1699","source":"Crossref","is-referenced-by-count":40,"title":["The Predictive Value of Inflammation at Ileocecal Resection Margins for Postoperative Crohn\u2019s Recurrence: A Cohort Study"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2295-238X","authenticated-orcid":false,"given":"Karin A T G M","family":"Wasmann","sequence":"first","affiliation":[{"name":"Dept. of surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jojanneke","family":"van Amesfoort","sequence":"additional","affiliation":[{"name":"Dept. of surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Dept. of pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurits L","family":"van Montfoort","sequence":"additional","affiliation":[{"name":"Dept. of pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianne","family":"Koens","sequence":"additional","affiliation":[{"name":"Dept. of pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem A","family":"Bemelman","sequence":"additional","affiliation":[{"name":"Dept. of surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christianne J","family":"Buskens","sequence":"additional","affiliation":[{"name":"Dept. of surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,12,27]]},"reference":[{"key":"2020102313005005600_CIT0001","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1038\/ajg.2009.579","article-title":"The natural history of adult Crohn\u2019s disease in population-based cohorts","volume":"105","author":"Peyrin-Biroulet","year":"2010","journal-title":"Am J Gastroenterol."},{"key":"2020102313005005600_CIT0002","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":"2020102313005005600_CIT0003","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1097\/00000658-199610000-00014","article-title":"Effect of resection margins on the recurrence of Crohn\u2019s disease in the small bowel. 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