{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:18Z","timestamp":1787014038201,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,11,13]],"date-time":"2018-11-13T00:00:00Z","timestamp":1542067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007587","name":"Fondation Aix-Marseille Universite","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      The introduction of biological agents and laparoscopy are, arguably, the most important developments for the treatment of Crohn's disease (\n                      <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                      ) in the last two decades. Due to the efficacy of biological agents in treating mild disease, it is likely that the percentage of surgery for complex cases may have increased. The objective of this study was to analyse the changing characteristics and results of the surgical treatment of patients with CD over the past 13 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      All patients who underwent abdominal surgery for\n                      <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                      between 2004 and 2016 were retrospectively identified. Data were compared between two periods (2004\u20132010 and 2011\u20132016).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 908 procedures were performed (48% men, mean age 43 \u00b1 16 years). Demographic and\n                      <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                      characteristics changed significantly over time: comorbidities were more frequent (35%\n                      <jats:italic>vs<\/jats:italic>\n                      46%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001), and preoperative steroids (28%\n                      <jats:italic>vs<\/jats:italic>\n                      36%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.01) and anti\u2010tumour necrosis factor (20%\n                      <jats:italic>vs<\/jats:italic>\n                      40%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001) treatments were more frequently used in the second period. Smoking (14%\n                      <jats:italic>vs<\/jats:italic>\n                      8%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001) and use of immunosuppressors (32%\n                      <jats:italic>vs<\/jats:italic>\n                      22%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) decreased significantly. More cases of penetrating disease (22%\n                      <jats:italic>vs<\/jats:italic>\n                      32%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) were operated upon in the second period. The laparoscopic approach (49%\n                      <jats:italic>vs<\/jats:italic>\n                      57%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.04) was more frequently performed and mean blood loss (167 \u00b1 222\n                      <jats:italic>vs<\/jats:italic>\n                      123 \u00b1 243 ml,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.01) decreased significantly. Postoperative morbidity did not change between the two periods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite a higher incidence of comorbidities and the use of biologics postoperative morbidity remained unchanged. An increased use of laparoscopy and a decreased intra\u2010operative blood loss may have contributed to offsetting the impact of increased comorbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.14450","type":"journal-article","created":{"date-parts":[[2018,10,20]],"date-time":"2018-10-20T05:29:47Z","timestamp":1540013387000},"page":"200-207","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Changing trends in surgery for abdominal Crohn's disease"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7556-6362","authenticated-orcid":false,"given":"D.","family":"Mege","sequence":"first","affiliation":[{"name":"Department of Surgery Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Garrett","sequence":"additional","affiliation":[{"name":"Department of Surgery Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Milsom","sequence":"additional","affiliation":[{"name":"Department of Surgery Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Sonoda","sequence":"additional","affiliation":[{"name":"Department of Surgery Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Michelassi","sequence":"additional","affiliation":[{"name":"Department of Surgery Weill Medical College of Cornell University New York New York 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