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We estimated pooled rates [with 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>)] of clinical and surgical recurrence, and risk factors for disease recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On meta\u2010analysis, the risk of clinical recurrence after <jats:styled-content style=\"fixed-case\">TC<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> was 28.0% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 21.7\u201335.3; 14 studies, 260\/1004 patients), with a 5 and 10\u2010year median cumulative rate of 23.5% (range, 7\u201335) and 40% (range, 11\u201360) respectively. The risk of surgical recurrence was 16.0% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 11.1\u201322.7; 10 studies; 183\/1092 patients), with a 5 and 10\u2010year median cumulative rate of 10% (range, 3\u201329) and 18.5% (range, 14\u201334) respectively. The risk of clinical and surgical recurrence in patients without ileal disease at baseline was 11.5% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 7.7\u201316.8) and 10.4% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 4.5\u201322.5) respectively. History of ileal disease was associated with 3.2 times higher risk of disease recurrence (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>, 3.2; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.8\u20135.6). Other inconsistent risk factors for disease recurrence were penetrating disease and young age at disease onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Small bowel clinical recurrence occurs in about 28% of patients after total colectomy with permanent ileostomy for colonic Crohn's disease. Disease recurrence risk is 3.2 times higher in patients with history of ileal disease, and continued medical therapy may be advisable in this population. In patients without ileal inflammation at surgery, continued endoscopic surveillance may identify asymptomatic disease recurrence to guide therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13886","type":"journal-article","created":{"date-parts":[[2016,12,8]],"date-time":"2016-12-08T06:13:44Z","timestamp":1481177624000},"page":"381-390","source":"Crossref","is-referenced-by-count":47,"title":["Systematic review with meta\u2010analysis: recurrence of Crohn's disease after total colectomy with permanent ileostomy"],"prefix":"10.1111","volume":"45","author":[{"given":"M.","family":"Fumery","sequence":"first","affiliation":[{"name":"Division of Gastroenterology University of California San Diego La Jolla CA USA"},{"name":"Gastroenterology Unit Amiens University and Hospital Universit\u00e9 de Picardie Jules Verne Amiens France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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