{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T08:03:42Z","timestamp":1790496222097,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T00:00:00Z","timestamp":1647216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:label\/><jats:p>There are conflicting data assessing the impact of isolated post\u2010operative anastomotic inflammation on future disease progression. The aim of this study was to determine the relative risk of severe disease progression in post\u2010operative Crohn\u2019s disease (CD) patients with isolated anastomotic disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study of adult CD patients undergoing ileocolonic resection between 2009 and 2020. Patients with a post\u2010operative ileocolonoscopy \u226418\u00a0months from surgery and \u22651 subsequent ileocolonoscopy were included. Disease activity was assessed using the modified Rutgeerts\u2019 score (RS). Primary outcome was severe endoscopic progression, defined as i3 or i4 disease, on immediate subsequent ileocolonoscopy and during entire post\u2010operative follow\u2010up. Secondary outcome was surgical recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and ninety\u2010nine CD patients had an ileocolonoscopy \u226418\u00a0months from surgery, index RS of i0\u2010i2b and \u22651 subsequent ileocolonoscopy. At index ileocolonoscopy, 34.7% had i0 disease, 16.1% i1, 24.6% i2a and 24.6% i2b. On multivariable logistic regression, i2b disease was associated with severe endoscopic progression compared to i0 or i1 (aOR 5.53; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and i2a disease patients (aOR 2.63; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03). However, i2a disease did not confer increased risk compared to i0 or i1 disease (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.09). Furthermore, i2b patients experienced severe endoscopic progression significantly earlier than i0 or i1 disease (aHR 4.68; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), whereas i2a disease did not differ from i0 or i1 disease (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.25). Surgical recurrence was not associated with index RS i0\u2010i2b (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.86).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Post\u2010operative ileal disease recurrence, not isolated anastomotic inflammation, confers increased risk for severe endoscopic disease progression. Location of CD recurrence may impact optimal management strategies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16804","type":"journal-article","created":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T09:59:22Z","timestamp":1647251962000},"page":"1139-1150","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Mild neoterminal ileal post\u2010operative recurrence of Crohn\u2019s disease conveys higher risk for severe endoscopic disease progression than isolated anastomotic lesions"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0226-7513","authenticated-orcid":false,"given":"Salam P.","family":"Bachour","sequence":"first","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi 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Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bret","family":"Lashner","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Paul","family":"Achkar","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Philpott","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9894-8796","authenticated-orcid":false,"given":"Edward L.","family":"Barnes","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of North Carolina at Chapel Hill  Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1951-7790","authenticated-orcid":false,"given":"Jordan","family":"Axelrad","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology New York University  New York City NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Holubar","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Department of Colorectal Surgery  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy L.","family":"Lightner","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Department of Colorectal Surgery  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Regueiro","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition  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