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Introduction

Studies evaluating the single incision laparoscopy (SIL) found an identical rate of postoperative complications and duration of hospitalization, with a probable aesthetic benefit compared to multi-trocar laparoscopy (MTL). The difference of a peri-umbilical or trans-umbilical incision has not been assessed in this young population.

Aims & Methods

The aim of this study was to compare the aesthetic result after ileocecal resection (ICR) for Crohn's by SIL or MTL.
All ileocecal resection with anastomosis (2012-2020) were retrospectively included. The aesthetic result was evaluated by the Body Image Questionnaire. A case-control study was carried out by matching on: age, sex, BMI, smoking, surgical history, surgical indication, corticosteroid therapy and associated procedure.

Results

206 patients (SIL=65; MTL=141) were included. Overall morbidity was 37.4% (severe morbidity=5.3%), with no difference between the groups. 124 patients (71%) responded to the questionnaire (mean follow-up: 4.7 years).
Body image was identical in both groups but the aesthetic scale was better in the SIL group (21.1 vs. 18.4, p<0.001). In the SIL group, body image was better in patients who had a trans-umbilical versus periumbilical incision (5.2 versus 6.4, p=0.04), the aesthetic scale was identical regardless of the incision.
After matching (SIL=37; MTL=37), body image remained identical in the two groups and the aesthetic scale remained better in the SIL group (21.1 vs. 19.3, p=0.03). The factors associated with a very good aesthetic result were the SIL and the absence of a history of abdominal surgery in univariate and in multivariate the SIL (OR=2.30[1.01-5.28], p=0.05).

Conclusion

The SIL for an ICR for Crohn's allows a better aesthetic result compared to the MTL, especially after trans-umbilical incision.

AESTHETIC BENEFIT OF ILEO-CAECAL RESECTION FOR CROHN'S DISEASE BY SINGLE TROCAR VERSUS CONVENTIONAL LAPAROSCOPY

Alice Antier 1, alexandre challine 1, Maxime Collard 1, Clotilde debove 1, Najim Chafai 1, Jeremie Lefevre 1, Yann Parc 1

1 Hopital Saint-Antoine General and Digestive Surgery, Paris, France

Conference

UEG Week Copenhagen 2023

Topics

IBD

Submission format

Abstract

Session

PP 05 IBD (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

UEG Presentation

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POSTOPERATIVE RECURRENCE IN CROHN'S DISEASE: COMPARING PROACTIVE VERSUS REACTIVE MANAGEMENT STRATEGIES AFTER ILEOCECAL RESECTION - A MULTICENTER RETROSPECTIVE STUDY

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Introduction

Postoperative recurrence is common in Crohn's disease following ileocecal resection, with varying management strategies employed. This study aimed to compare the efficacy of prophylactic approach (starting thiopurines or biological therapy within 6 months from the surgery) versus reactive one (starting biological therapy after evidence of disease reactivation) in preventing postoperative recurrence.

Aims & Methods

This retrospective, multicenter study included 895 adult patients who underwent ileocecal resection for Crohn's disease across 13 Italian centers (prophylactic strategy: n=196; reactive strategy: n=699). Patients were classified as high-risk (≥1 risk factor: active smoking, prior intestinal resection, penetrating disease, perianal disease, or large resection ≥50 cm) or low-risk. The primary outcome was endoscopic recurrence (Rutgeerts' score ≥i2a) at 6-12 months post-surgery. Secondary outcomes included clinical, biochemical, and radiological recurrence at various time points, as well as long-term outcomes including need for repeat surgery.

Results

The prophylactic biologic therapy group demonstrated significantly lower rates of endoscopic recurrence at 6-12 months compared to the reactive approach (51.54% vs. 64.83%, p=0.007). After adjusting for confounders, including age at surgery and previous biologic exposure, a reactive approach was associated with increased odds of endoscopic recurrence (OR 1.893, 95% CI: 1.225-2.926, p=0.004). The prophylactic strategy also showed lower rates of clinical recurrence (23.08% vs. 36.36%, p=0.002), biochemical recurrence (33.81% vs. 48.89%, p=0.004), and severe endoscopic recurrence (22.31% vs. 32.55%, p=0.028) at 6-12 months. In high-risk patients with a single risk factor, prophylaxis significantly reduced endoscopic recurrence (49.06% vs. 65.75%, p=0.033) and surgical recurrence (2.56% vs. 11.58%, p=0.017). For patients with multiple risk factors, benefits were mainly observed in clinical (29.87% vs. 45.77%, p=0.022) and biochemical recurrence (37.88% vs. 56.32%, p=0.024). In low-risk patients, prophylaxis primarily reduced severe endoscopic recurrence (10.52% vs. 34.48%, p=0.037), but not other outcomes. However, these benefits diminished over time, with no significant differences in all outcomes at 15-36 months or in long-term surgical recurrence rates as compared to patients undergoing the reactive approach in all groups (p=0.438). No significant difference was observed between the two approaches regarding the need for endoscopic dilation during follow-up (p=0.301).

Table 1: Differences in outcomes at 6-12 months between a proactive and reactive strategy approach. Abbreviations: CD: Crohn's Disease, FC: Fecal Calprotectin, HBI: Harvey-Bradshaw Index

Characteristic	Proactive strategy	Reactive strategy	p-value
	n=352	n=543
Early biochemical recurrence ~3 months (FC ≥ 150 μg/g, n, %))	21 (42.9)	37 (60.7)	0.063
Clinical recurrence ~6–12 months (HBI ≥5, n, %))	57 (24.3)	134 (38.1)	<0.001
Biochemical recurrence ~6–12 months (FC ≥ 150 μg/g), n (%)	65 (35.9)	114 (50.0)	0.004
Endoscopic recurrence ~6–12 months (SES-CD ≥3 or Rutgeerts ≥2), n (%)	111 (56.1)	203 (64.9)	0.047
Severe endoscopic recurrence ~6–12 months (SES-CD ≥16 or Rutgeerts ≥3), n (%)	49 (24.7)	104 (33.2)	0.041
Radiological recurrence ~6–12 months (n, %)	70 (49.0)	122 (52.8)	0.468
Any CD complication ~6–12 months (n, %)	29 (8.2)	46 (8.5)	0.902

Conclusion

A prophylactic strategy significantly reduces short-term postoperative recurrence in Crohn's disease patients following ileocecal resection, with particular benefit in high-risk patients with a single risk factor. However, the protective effects appear to diminish over time. Further research is needed to refine predictive models and validate interventions targeting high-risk populations for sustained benefits.

POSTOPERATIVE RECURRENCE IN CROHN'S DISEASE: COMPARING PROACTIVE VERSUS REACTIVE MANAGEMENT STRATEGIES AFTER ILEOCECAL RESECTION - A MULTICENTER RETROSPECTIVE STUDY

Luisa Bertin 1, Benedetta Masoni 2, Silvia Ferretti 2, Alessandro Armuzzi 2, Cristina Bezzio 2, Miriana Zanconato 1, Gianluca Semprucci 1, Davide Giuseppe Ribaldone 3, Adele Capello 3, Giorgia Bodini 4, ANDREA PASTA 4, Francesco Calabrese 4, Linda Ceccarelli 5, Francesco Costa 5, Lorenzo Bertani 6, Marco Marino 7, Luca Navarria 7, Gianluca Benevento 8, Renato Sablich 8, Marta Ascolani 9, Andrea Buda 10, Gaia Riguccio 10, Nicoletta Merlini 11, Elisabetta Dal Pont 12, Daniele Canova 13, Edoardo Vincenzo Savarino 1, Fabiana Zingone 1

1 University of Padova, Padova, Italy

2 IBD Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

3 University of Turin, Turin, Italy

4 Policlinico San Martino, Genova, Italy

5 AOU Pisa, Pisa, Italy

6 University of Pisa, Pisa, Italy

7 Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy

8 Ospedale S.Maria degli Angeli, Pordenone, Italy

9 Ospedale Ca'Foncello, Treviso, Italy

10 Ospedale di Santa Maria del Prato di Feltre, Feltre, Italy

11 Ospedale Vittorio Emanuele III, Montecchio, Italy

12 Ospedale San Martino di Belluno, Belluno, Italy

13 San Bortolo Hospital, Vicenza, Italy

Event

UEG Week Berlin 2025

Topics

IBD

Submission format

Abstract

Session

Predicting clinical outcomes in IBD

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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… after ileocecal resection of localised Crohn's disease

Matthieu Allez 1

1 Saint-Louis Hospital, AP-HP, Université Paris Cité, Paris, France

Event

UEG Week Berlin 2025

Topics

Colorectal IBD Surgery

Session

Predicting patient outcomes...

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

Ileocecal resection (ICR) is the most common surgical procedure for ileal Crohn's disease (CD). Data is growing to suggest ICR in localized disease as a first-line treatment instead of biologics to maintain long-term remission. However, removal of the ileocecal valve has a detrimental effect on bowel transit and disabling symptoms may occur after surgery. We aimed to assess the impact of a primary ICR on the daily symptoms of patients with CD.

Aims & Methods

All patients who underwent a primary ileocecal resection at the Saint-Antoine Hospital between January 2017 and December 2022 were included. Patients were followed up with post-operative visits before and after Rutgeerts score assessment. Patients' daily symptoms were recorded using a dedicated database (SUVIMIC), the routine software used at the Saint-Antoine Hospital that includes assessment of patient reported outcomes.

Results

Between 2017 and 2022, 110 patients underwent primary ICR for CD in relapse at the Saint-Antoine Hospital. The median disease duration at surgery was 6 years (IQR 1–11). The indications for surgery were fistulizing CD phenotype for 62 patients (56.4%) and strictures for 40 patients (36.4%). Only 7 patients (6.4%) had inflammatory phenotype at the time of first ICR. The median time to Rutgeerts Score assessment was 7 months showing 75 patients (68.2%) in remission defined as a score of i0, i1, i2a and 35 patients (31.8%) in relapse with a score of i2b to i4. Patients' daily symptoms reported at endoscopic assessment (6 – 12 months after surgery) are shown in Table 1. According to disease activity, the prevalence of diarrhea, defined as liquid stools, was 58.7% in patients in remission and 54.3% in patients in relapse. The prevalence of fecal urgency was 22.7% and 25.7%, respectively. Fecal incontinence was present in one patient in remission and three patients in relapse. According to the length of the resected small bowel, liquid stools were observed in 61.7% of patients with short resections (≤ 20 cm), 45.7% of patients with resections between 21 - 40 cm and 76.5% of patients with long resections (≥ 41 cm). Fecal urgency was present in 25.5%, 13.0% and 47.1% respectively. Furthermore, the prevalence of abdominal pain was 31.8% and of fatigue 34.5% in the whole cohort.

Table 1. Daily symptoms of patients after primary ileocecal resection at endoscopic assessment

Patients’ daily symptoms	According to disease activity		According to small bowel removed
Patients’ daily symptoms	Remission n = 75	Relapse n = 35	Short resection ≤ 20 cm n = 47	Resection 21 – 40 cm n = 46	Long resection ≥ 41 cm n = 17
Liquid stools	44 (58.7)	19 (54.3)	29 (61.7)	21 (45.7)	13 (76.5)
> 3 liquid stools per day	7 (9.3)	6 (17.1)	7 (14.9)	2 (4.3)	4 (23.5)
Number of liquid stools per day *mean* (SD)	1.4 (1.5)	1.9 (1.5)	1.8 (2.4)	1.1 (1.5)	2.1 (1.7)
Fecal urgency	17 (22.7)	9 (25.7)	12 (25.5)	6 (13.0)	8 (47.1)
Fecal incontinence	1 (1.3)	3 (8.6)	1 (2.1)	1 (2.2)	2 (11.8)
Anti-diarrheal medications	17 (22.7)	7 (20.0)	9 (19.2)	11 (23.9)	4 (23.5)
Abdominal pain	21 (28.0)	14 (40.0)	15 (31.9)	12 (26.1)	8 (47.1)
Fatigue	24 (32.0)	14 (40.0)	15 (31.9)	16 (34.8)	7 (41.2)

Symptoms are expressed in number of patients (%). Remission was defined as a Rutgeerts score i0, i1, i2a and relapse i2b, i3 and i4.

Conclusion

The prevalence of digestive symptoms after primary ICR for CD is high, especially diarrhea and fecal urgency, even in patients in remission. Primary ICR for CD is an effective treatment for achieving long-term remission, but removal of the ileocecal valve leads to irreversible changes in bowel transit, which must be considered before proposing surgery.

FUNCTIONAL OUTCOMES AFTER PRIMARY ILEOCECAL RESECTION FOR CROHN’S DISEASE

Nathan Grellier 1, Julien Kirchgesner 2, Najim Chafai 3, Isabelle Nion larmurier 2, Clotilde debove 3, Anne Bourrier 2, Cecilia Landman 2, Paul McLellan 2, Harry Sokol 2, Jeremie Lefevre 3, Philippe Seksik 2, Laurent Beaugerie 2

1 Saint-Antoine Hospital - Department of Gastroenterology, Paris, France|||Poitiers University Hospital, Poitiers, France

2 Saint-Antoine Hospital - Department of Gastroenterology, Paris, France

3 Saint-Antoine Hospital, Paris, France

Conference

UEG Week Vienna 2024

Topics

IBD

Submission format

Abstract

Session

Surgical considerations in IBD (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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Introduction

Redoing an ileal pouch-anal anastomosis (IPAA) is a rare scenario but the only solution to effectively manage chronic surgical failures. The aim was to compare short- and long-term outcomes after redo-IPAA.

Aims & Methods

All patients who underwent IPAA surgery (primary or redo-IPAA) between 2010 and 2023 were included in this single-center study. Morbidity and ileal-pouch survival were collected. Patients were also administered questionnaires assessing bowel function with the Ileal Pouch Severity Score (IPSS) and the quality of life with the SF36.

Results

380 primary-IPAA were performed during the inclusion period. Among them, 4% (n=17) required a redo-IPAA. 15 patients were referred to our centre for redo-IPAA. Therefore, 32 patients with redo-IPAA were included. Indication for redo-IPAA were chronic leakage from the previous IPAA (n=15), endoscopically unresectable ileal pouch polyps in FAP patients (n=9), IPAA stenosis (n=4), poor functional results (n=2), twist of the ileal pouch (n=1), invasive adenocarcinoma of the ileal pouch (n=1). Patients had been operated initially for Ulcerative Colitis (n=11), Familial polyposis (n=18) or other causes (n=3).
Median time interval from primary to redo-IPAA was 1.1 years with a minimum of 0.3 year and a maximum of 36 years. The anastomosis was handsewn in 97% of redo-IPAA versus 79% of primary-IPAA (p=0.018). Manoeuvres to increase mesenteric length were never required during redo-IPAA, whereas it was in 27% of primary-IPAA (p<0.001). A diverting stoma to protect the IPAA was performed in 44% of primary-IPAA and in 69% of redo-IPAA (p=0.007). Overall postoperative morbidity was lower after redo-IPAA (25%) compared to primary-IPAA (47%, p=0.016), as well as hospital stay duration (median 7 days versus 9 days, p=0.003). Severe morbidity (redo-IPAA: 16%, primary-IPAA: 21%, p=0.458) and anastomotic leakage rate (redo-IPAA: 6%, primary-IPAA: 14%, p=0.286) did not differ. Post-operative mortality was nil after redo-IPAA and was 0.3% (1 patient) after primary-IPAA. No patient developed short bowel syndrome.
After a median follow-up of 48 months, ileal-pouch survival was similar between redo-IPAA and primary-IPAA groups (5-year ileal-pouch survival: 82% versus 90% respectively, log-rank test: p=0.250). Long-term rate of anastomotic stenosis was similar after redo-IPAA (18%) compared to primary-IPAA (12%, p=0.365). Among patients with a technical success of the IPAA procedure, the rate of definitive stoma due to a poor bowel functional result was 14% after redo-IPAA versus 8% after primary-IPAA (p=0.401). Long-term bowel function was significantly worse after redo-IPAA (median IPSS score: 56/100) compared to primary-IPAA (median IPSS score: 41/100, p=0.007), without impacting quality of life measured by the SF36 score (physical component summary: redo-IPAA: 49/100, primary-IPAA: 50/100, p=0.501 and mental component summary: redo-IPAA: 41/100, primary-IPAA: 45/100, p=0.078).

Conclusion

Redo-IPAA is feasible with acceptable post-operative morbidity as it showed a similar rates of severe complications, anastomotic leakage, and ileal-pouch survival compared to primary-IPAA. Functional outcomes is worse compared to primary-IPAA but avoid a definitive ileostomy. After a technical success of redo-IPAA, 14% of patients asked for a definitive stoma due to a poor bowel function, thus 86% of patients preferred to maintain digestive continuity with the achieved functional outcome rather than opting for a permanent ileostomy.

COMPARATIVE ANALYSIS OF SHORT- AND LONG-TERM RESULTS BETWEEN REDO AND PRIMARY ILEAL-POUCH ANAL ANASTOMOSIS PROCEDURES: A CRITICAL EXAMINATION

Théo Braquet 1, Maxime Collard 1, alexandre challine 1, Clotilde debove 1, Najim Chafai 1, Yann Parc 1, Jeremie Lefevre 1

1 Hopital Saint-Antoine General and Digestive Surgery, Paris, France

Conference

UEG Week Vienna 2024

Topics

IBD

Submission format

Abstract

Session

Surgical considerations in IBD (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

UEG Presentation

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WHAT IS THE RATE OF DEFINITIVE STOMA AFTER SUBTOTAL COLECTOMY FOR INFLAMMATORY BOWEL DISEASE? A NATIONWIDE STUDY OF 1860 PATIENTS

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Introduction

Some patients with inflammatory bowel disease require subtotal colectomy with ileostomy electively or in emergency as the first step of surgical treatment. Secondary proctectomy with ileal pouch anal anastomosis or ileorectal anastomosis can be considered for bowel continuity restoration. However, recent literature reports a significant number of patients who do not undergo subsequent surgery and are resigned to live with a definitive end ileostomy.

Aims & Methods

Assess the rate and cumulative incidence of secondary reconstructive surgery after subtotal colectomy for inflammatory bowel disease and identify the risk factors associated with the absence of a completion procedure in a large national cohort study.
A national retrospective study from 2013 and 2021 was conducted on prospective collected data from the French Medical Information System Database (PMSI). All patients undergoing subtotal colectomy in France for inflammatory bowel disease were included. Cumulative incidence of reconstruction surgery either with proctectomy and ileal pouch anal anastomosis or with ileorectal anastomosis was calculated by means of a Kaplan-Meier survival curve. The association between the absence of a subsequent intervention and potential risk factors was studied using univariate and multivariate analyses.

Results

1860 patients were included (45 +/-19 years old), with a median follow-up of 30 months. 77% (n=1442) presented an ulcerative colitis and 23% (n=418) a Crohn’s disease. Mortality and morbidity at 90 days after subtotal colectomy were 5% (n=100) and 47% (n=868). Reconstructive surgery was identified in 1255 patients (67%) with a mean time of 7 months. 74% (n=932) underwent a completion proctectomy with ileal pouch anal anastomosis and 26% (n=323) an ileorectal anastomosis. Among patients with a permanent ileostomy who did not have bowel continuity restorative surgery (33%, n=605), 19% (n=114) had an abdominoperineal resection and 81% (n=491) did not had any further surgical procedure after subtotal colectomy. Independent risk factors for definitive end ileostomy identified in multivariate analysis were older age, Crohn’s disease, colic neoplasia, postoperative complication after subtotal colectomy, laparotomy, and low volume centre.

		Permanent ileostomy (605)	Reconstructive surgery (1255)	Adjusted hazard ratio (95% CI)	p-value
Age at the time of STC, mean (SD)		55.0 (20.5)	40.9 (16.2)	1.01 (1.01-1.02)	<0.001
STC for cancer, n (%)	No Yes	566 (94%) 39 (6%)	1226 (98%) 29 (2%)	1 1.73 (1.22-2.46)	0.002
IBD type, n (%)	Crohn’s disease Ulcerative colitis	211 (35%) 394 (65%)	207 (16%) 1048 (84%)	1 0.82 (0.68-0.98)	0.033
Postoperative morbidity, n (%)	No Yes	236 (39%) 369 (61%)	756 (60) 499 (40)	1 1.22 (1.02-1.46)	0.033
Surgical approach, n (%)	Laparotomy Laparoscopy	282 (47%) 323 (53%)	234 (19%) 1021 (81%)	1 0.71 (0.58-0.85)	<0.001
Hospital volume n (%)	High (> 150/y) Medium Low (<50/y)	390 (65%) 153 (25%) 62 (10%)	896 (71%) 295 (24%) 64 (5%)	1 0.92 (0.76-1.13) 1.41 (1.05-1.89)	0.435 0.021

Conclusion

In this large national cohort study, 67% of patients undergoing subtotal colectomy with ileostomy for inflammatory bowel disease were treated with reconstructive surgery. This rate is higher than previously reported in other population-based studies. Absence of reconstructive surgery is associated with age, Crohn’s disease, colic neoplasia, post-operative morbidity, laparotomy, and low volume centre.

WHAT IS THE RATE OF DEFINITIVE STOMA AFTER SUBTOTAL COLECTOMY FOR INFLAMMATORY BOWEL DISEASE? A NATIONWIDE STUDY OF 1860 PATIENTS

Julie Deyrat 1, alexandre challine 1, Thibault Voron 1, Lauren O Connell 2, Maxime Collard 1, Sabine Tzedakis 3, Romain Jacquet 3, Andre Lazzati 4, Yann Parc 1, Jeremie Lefevre 1

1 Hopital Saint-Antoine General and Digestive Surgery, Paris, France

2 St Vincent's University Hospital, Dublin, Ireland

3 INRIA, Paris, France

4 CHU Creteil, Creteil, France

Event

UEG Week Copenhagen 2023

Topics

IBD Surgery

Submission format

Abstract

Session

Unsolved issues in IBD outcome

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Introduction

While ileocecal resection (ICR) is the most common surgical procedure in Crohn's disease (CD), non-ICR surgeries account for only 20% of cases and remain underrepresented in the literature. This study aimed to identify specific clinical risk factors for surgical recurrence in CD patients undergoing small bowel or colonic resections without involving the ileocecal valve.

Aims & Methods

This multicenter retrospective cohort study included 257 patients with CD (124 small bowel resections, 133 colonic resections) across 13 Italian centers from 1978 to 2023. Univariate and multivariate logistic regression and Cox proportional hazards analyses were performed to identify clinical risk factors associated with surgical recurrence.

Results

The cohort comprised two distinct groups: small bowel resections (n=124), characterized by male predominance (63.71%), a high prevalence of stricturing disease (60.48%), and a median follow-up of 75.5 months; and colonic resections (n=133), featuring a more balanced gender distribution (47.37% male), higher rates of penetrating disease (47.37%), and a median follow-up of 88.0 months. Penetrating disease behaviour emerged as the only significant predictor of recurrence in logistic regression analysis (OR 2.16, 95% CI 1.03-4.52, p=0.041), while factors typically predictive in ICR, such as smoking (OR 0.90, p=0.843) and prior resections (OR 0.96, p=0.913), were non-significant. Cox regression identified prior biologic exposure as a significant predictor of earlier recurrence (HR 2.52, 95% CI 1.22-5.18, p=0.012), with TNF experience specifically associated with increased risk (HR 2.28, 95% CI 1.12-4.67, p=0.024). The cumulative number of risk factors (HR 1.35, 95% CI 1.01-1.82, p=0.046) and postoperative intra-abdominal septic complications (HR 2.75, 95% CI 1.18-6.44, p=0.020) also contributed to recurrence risk. Disease phenotypes significantly differed between resection types (p<0.001), with stricturing disease most prevalent in small bowel resections (60.48% vs. 36.09% in colonic) and penetrating disease more common in colonic resections (47.37% vs. 36.29% in small bowel). Results are summarized in Table 1.

Table 1: Univariate logistic regression analysis of predictors for postoperative surgical recurrence in patients undergoing small bowel or colonic resections. Abbreviations: CI: Confidence Interval; CD: Crohn’s Disease; IBD: Inflammatory Bowel Disease; POR: Postoperative recurrence; TNF: Tumour Necrosis Factors.

Predictor	Odds Ratio	95% CI Lower Bound	95% CI Upper Bound	p-value
Penetrating behaviour (B3, Montreal classification)	2.160	1.033	4.517	0.041
Large intestinal resection (≥50 cm)	2.090	0.982	4.450	0.056
Postoperative complications (within 30 days from surgery)	1.801	0.717	4.525	0.211
Age at diagnosis 17-40 years old (A2, Montreal classification)	2.099	0.906	4.861	0.084
≥ 1 known clinical POR risk factor after ileocecal resection	1.651	0.607	4.493	0.326
Surgery for penetrating complication	1.534	0.666	3.532	0.352
Colonic localization (L2, Montreal classification)	1.428	0.601	3.393	0.419
Number of postoperative recurrences known risk factors after ileocecal resection	1.351	0.976	1.870	0.069
Smoking at time of surgery	1.224	0.518	2.893	0.644

Conclusion

This study reveals distinct risk factors for surgical recurrence after non-ICR surgeries in CD. Unlike ICR where smoking, perianal disease, and prior resections predominate, non-ICR recurrence is primarily associated with penetrating disease phenotype and prior biologic exposure. These findings demonstrate that risk stratification models developed for ICR are not applicable to non-ICR surgeries, highlighting the need for procedure-specific approaches to postoperative management. Tailored prophylactic strategies should address the unique recurrence dynamics of small bowel and colonic resection surgeries.

BEYOND ILEOCECAL: RISK FACTORS AND RECURRENCE PATTERNS IN NON-ILEOCECAL CROHN'S DISEASE RESECTIONS

Luisa Bertin 1, Benedetta Masoni 2, Silvia Ferretti 2, Alessandro Armuzzi 2, Cristina Bezzio 2, Miriana Zanconato 1, Gianluca Semprucci 1, Davide Giuseppe Ribaldone 3, Adele Capello 3, Giorgia Bodini 4, Francesco Calabrese 4, ANDREA PASTA 4, Linda Ceccarelli 5, Francesco Costa 5, Lorenzo Bertani 6, Marco Marino 7, Luca Navarria 7, Gianluca Benevento 8, Renato Sablich 8, Marta Ascolani 9, Andrea Buda 10, Gaia Riguccio 10, Nicoletta Merlini 11, Elisabetta Dal Pont 12, Daniele Canova 13, Fabiana Zingone 1, Edoardo Vincenzo Savarino 1

1 University of Padova, Padova, Italy

2 IBD Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

3 University of Turin, Turin, Italy

4 Policlinico San Martino, Genova, Italy

5 AOU Pisa, Pisa, Italy

6 University of Pisa, Pisa, Italy

7 Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy

8 Ospedale S.Maria degli Angeli, Pordenone, Italy

9 Ospedale Ca'Foncello, Treviso, Italy

10 Ospedale di Santa Maria del Prato di Feltre, Feltre, Italy

11 Ospedale Vittorio Emanuele III, Montecchio, Italy

12 Ospedale San Martino di Belluno, Belluno, Italy

13 San Bortolo Hospital, Vicenza, Italy

Conference

UEG Week Berlin 2025

Topics

IBD

Submission format

Abstract

Session

Crohn's disease: Postoperative course and outcomes (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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