{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:44:44Z","timestamp":1792759484160,"version":"4.5.0"},"reference-count":11,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The concept of \u2018early surgery\u2019 for ileocaecal Crohn's disease (CD) has gained traction since the LIR!C trial demonstrated that laparoscopic ileocaecal resection is a cost\u2010effective alternative to infliximab for uncomplicated terminal ileitis. However, the term \u2018early\u2019 is imprecisely defined, temporally misleading and difficult to operationalise in clinical practice. This article aims to propose a more useful clinical framework for the timing of ileocaecal resection in CD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We critically appraised the 10\u2010year follow\u2010up of the LIR!C trial, together with population\u2010based and pooled observational data comparing ileocaecal resection with continued medical therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Current evidence suggests that resection may be superior to continued medical therapy in selected patients. It is associated with higher rates of therapy\u2010free remission and less need for subsequent surgery. Operating before complications develop is also associated with better perioperative outcomes. We propose distinguishing between reactive surgery, meaning operating in response to complications that have already developed, and strategic surgery. Strategic surgery is a proactive, multidisciplinary decision to offer ileocaecal resection at the optimal point in the disease course. It is based on phenotype, patient condition and shared decision\u2010making, rather than on elapsed time or biological exposure alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The evidence underpinning this position is largely retrospective and subject to selection bias. Substantial clinician, patient and health\u2010system barriers stand in the way of implementation. Prospective data are needed before guideline revision is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70652","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:13:11Z","timestamp":1792170791000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond \u2018early surgery\u2019: Reframing Ileocaecal resection as strategic care in Crohn's disease"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1493-1768","authenticated-orcid":false,"given":"Antonino","family":"Spinelli","sequence":"first","affiliation":[{"name":"Division of Colon and Rectal Surgery IRCCS Humanitas Research Hospital  Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6802-7125","authenticated-orcid":false,"given":"Nicolas","family":"Avellaneda","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Section GMColoproctolog\u00eda Institute  Buenos Aires Argentina"},{"name":"IBD Surgical Section Inmunolog\u00eda Buenos Aires  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1572-0118","authenticated-orcid":false,"given":"Alessandro","family":"Armuzzi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"},{"name":"IBD Unit IRCCS Humanitas Research Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_2_2_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjw169"},{"key":"e_1_2_2_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjv184"},{"key":"e_1_2_2_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30248-0"},{"key":"e_1_2_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(20)30117-5"},{"key":"e_1_2_2_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(25)00374-7"},{"key":"e_1_2_2_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.05.051"},{"key":"e_1_2_2_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.16502"},{"key":"e_1_2_2_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.17056"},{"key":"e_1_2_2_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(24)00034-7"},{"key":"e_1_2_2_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.70042"},{"key":"e_1_2_2_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30294-7"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.70652","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.70652","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.70652","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:11:48Z","timestamp":1792757508000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.70652"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":11,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/codi.70652"],"URL":"https:\/\/doi.org\/10.1111\/codi.70652","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-09-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70652"}}