{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:36:21Z","timestamp":1792841781315,"version":"4.5.0"},"reference-count":72,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T00:00:00Z","timestamp":1718582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Risk stratification for endoscopic post\u2010operative recurrence (ePOR) in Crohn's disease (CD) is required to identify patients who would benefit most from initiation of prophylactic medication and intensive monitoring of recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the current evidence on patient\u2010related, microbial, surgical and histopathological risk factors for ePOR in patients with CD after ileocolic (re\u2010)resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multiple online databases (Embase, MEDLINE, Web of Science and Cochrane Library) were searched up to March 2024. Studies with reported associations of patient\u2010related, microbial, surgical and\/or histopathological factors for ePOR (i.e., Rutgeerts\u2019 score \u2265i2 or modified Rutgeerts\u2019 score \u2265i2a) were included. The risk of bias was assessed with the Newcastle\u2010Ottawa Scale for observational cohort studies and case\u2010control studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 47 studies were included (four RCTs, 29 cohort studies, 12 case\u2013control studies, one cross\u2010sectional study and one individual participant data meta\u2010analysis) including 6006 patients (median sample size 87 patients [interquartile range 46\u2013170]). Risk of bias assessment revealed a poor quality in 41% of the studies. An association was reported in multiple studies of ePOR with active smoking at and post\u2010surgery, male sex and prior bowel resection. A heterogeneous association with ePOR was reported for other risk factors included in the current guidelines (penetrating disease, perianal disease, younger age, extensive small bowel disease and presence of granulomas in the resection specimen or myenteric plexitis in the resection margin), and other patient\u2010related, microbial, surgical and histopathological factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Risk factors for ePOR in international guidelines are not consistently reported as risk factors in current literature except for active smoking and prior bowel resection. To develop evidence\u2010based, personalised strategies, large prospective studies are warranted to identify risk factors for ePOR. Validation studies of promising (bio)markers are also required.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.18040","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T05:44:02Z","timestamp":1718689442000},"page":"310-326","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Systematic review: Patient\u2010related, microbial, surgical, and histopathological risk factors for endoscopic post\u2010operative recurrence in patients with Crohn's disease"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8515-425X","authenticated-orcid":false,"given":"Michiel T. 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