{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:16:38Z","timestamp":1788336998384,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"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":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early endoscopic evaluation is recommended for assessment of postoperative recurrence (POR) of Crohn's disease (CD) but no further monitoring recommendations are available.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the long\u2010term outcome of patients without endoscopic POR at first endoscopic assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective four\u2010centre study including consecutive CD patients with ileocolonic resection (ICR) without endoscopic POR (Rutgeerts score i0\u2010i1) at first endoscopic assessment performed within 18\u2009months from ICR. All patients had a clinical follow\u2010up \u226524\u2009months and at least one further endoscopic assessment. Main outcomes were endoscopic, clinical and surgical POR, need for rescue therapy and \u201cdelayed POR\u201d (any need for rescue therapy or clinical or surgical POR) during follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 183 patients were included (79% with risk factors for POR, 44% without postoperative prophylaxis). Endoscopic POR was observed in 42% of patients. Clinical POR\u2010free survival was 89.4% and 81.5% at 3 and 5\u2009years, and delayed POR\u2010free survival was 76.9% and 63.4% at 5 and 10\u2009years, respectively. In multivariate analysis, postoperative prophylaxis (HR .55; 95% CI .325\u2013.942) and active smoking (HR 1.72; 95%CI 1.003\u20132.962) were independent risk factors for clinical POR, whereas presence of mild endoscopic lesions at index ileocolonoscopy (i1) was the only risk factor for delayed POR (HR 1.824; 95% CI 1.108\u20133.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Long\u2010term risk of POR among patients with no or mild endoscopic lesions at first ileocolonoscopy after surgery is steadily low, being higher among smokers, in the absence of postoperative prophylaxis and when mild endoscopic lesions are observed in the first endoscopic assessment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.14219","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T12:09:10Z","timestamp":1713787750000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Long\u2010term risk of delayed postoperative Crohn's disease recurrence in patients with no or mild endoscopic recurrence at first assessment"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9051-2581","authenticated-orcid":false,"given":"M\u00edriam","family":"Ma\u00f1osa","sequence":"first","affiliation":[{"name":"IBD Unit, Gastroenterology Department Hospital Universitari Germans Trias i Pujol  Badalona Catalonia Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Madrid 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