Evidence map›Paper›PMID 29309546›Full record

ArticleJournal of Crohn's & colitis2018

Inclusion of the Mesentery in Ileocolic Resection for Crohn's Disease is Associated With Reduced Surgical Recurrence.

Calvin J Coffey, Miranda G Kiernan, Shaheel M Sahebally, Awad Jarrar, John P Burke, Patrick A Kiely, Bo Shen, David Waldron, Colin Peirce, Manus Moloney and 13 more

4 registry-linked trialsOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of Crohn's & colitis, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 161 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
161citing papers in PubMed, 13 pooled it
32.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03769922 naunknown statusnot on this mapstarted 2019, after this paper: background citation

The MESOCOLIC Trial: Mesenteric Excision Surgery or Conservative Limited Resection in Crohn's Disease

TypeinterventionalSponsorJinling Hospital, ChinaRan2019 to 2025Enrolled116ConditionsPostoperative Surgical RecurrenceArmsExtensive mesenteric resection, Limited mesenteric excision
NCT04578392 naterminatednot on this mapstarted 2020, after this paper: background citation

MeSenteric SpAring Versus High Ligation Ileocolic Resection for the Prevention of REcurrent Crohn's DiseaSe (SPARES)

TypeinterventionalSponsorThe Cleveland ClinicRan2020 to 2023Enrolled13ConditionsCrohn DiseaseArmshigh ligation of ileocolic artery, mesenteric sparing
NCT07164209 nacompletednot on this mapstarted 2022, after this paper: background citation

Resection of the Mesentery With Functional End-to-end Anastomosis vs Kono Anastomosis in Preventing Relapse After Ileocolic Resection for Primary Crohn Disease: a Prospective, Randomized, Controlled Trial Remeasure CD TRial

TypeinterventionalSponsorAzienda Ospedaliera Ordine Mauriziano di TorinoRan2022 to 2024Enrolled73ConditionsIleocolic Crohn Disease, Kono S Anastomosis, Resection of the MesenteryArmsExcision of the mesentery: the mesentery is fully dissected and excised to the limit of macroscopic "fat wrapping", where mesenteric fat is inflamed and extends beyond its normal anatomical distribut, Kono S Anastomosis
NCT07231601 recruitingnot on this mapstarted 2022, after this paper: background citation

Laparoscopic Mesenteric Excision and Exclusion for Crohn's Disease of the Terminal Ileum. A Greek Single Center Study.

Typeobservational_patient_registrySponsorTzaneio General HospitalRan2022 to 2032Enrolled50ConditionsCrohn Disease (CD), Crohn Disease of Ileum, Kono S Anastomosis, Extended Mesenteric ExcisionArmsMesenteric excision and exclusion
3 · Its place in the literature

Who cites it

161 citing papers in PubMed, 13 syntheses or guidelines pooled it, 342 citations in OpenAlex.

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101 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors at 8 institutions in 2 countries.

Calvin J CoffeyDepartment of Surgery, University Hospital Limerick, Limerick, Ireland.
Miranda G KiernanGraduate Entry Medical School, University of Limerick, Limerick, Ireland.
Shaheel M SaheballyDepartment of Surgery, University Hospital Limerick, Limerick, Ireland.
Awad JarrarLerner College of Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
John P BurkeCentre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland.
Patrick A KielyGraduate Entry Medical School, University of Limerick, Limerick, Ireland.
Bo ShenLerner College of Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
David WaldronDepartment of Surgery, University Hospital Limerick, Limerick, Ireland.
Colin PeirceDepartment of Surgery, University Hospital Limerick, Limerick, Ireland.
Manus MoloneyDepartment of Gastroenterology, University Hospitals Limerick, Limerick, Ireland.
Maeve SkellyDepartment of Gastroenterology, University Hospitals Limerick, Limerick, Ireland.
Paul TibbittsDepartment of Surgery, University Hospital Limerick, Limerick, Ireland.
Hena HidayatDepartment of Surgery, University Hospital Limerick, Limerick, Ireland.
Peter N FaulDepartment of Pathology, University Hospitals Limerick, Limerick, Ireland.
Vourneen HealyDepartment of Pathology, University Hospitals Limerick, Limerick, Ireland.
Peter D O'LearyDepartment of Surgery, University Hospital Limerick, Limerick, Ireland.
Leon G WalshDepartment of Surgery, University Hospital Limerick, Limerick, Ireland.
Peter DockeryDepartment of Anatomy, National University of Ireland Galway, Galway, Ireland.
Ronan P O'ConnellCentre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland.
Sean T MartinCentre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland.
Fergus ShanahanDepartment of Medicine, Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland.
Claudio FiocchiDepartments of Gastroenterology/Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Colum P DunneGraduate Entry Medical School, University of Limerick, Limerick, Ireland.
University Hospital Limerick · IEUniversity of Limerick · IECleveland Clinic Lerner College of Medicine · USSt. Vincent's University Hospital · IECleveland Clinic · USOllscoil na Gaillimhe – University of Galway · IEUniversity College Cork · IEUniversity College Dublin · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsInclusion of the mesentery during resection for colorectal cancer is associated with improved outcomes but has yet to be evaluated in Crohn's disease. This study aimed to determine the rate of surgical recurrence after inclusion of mesentery during ileocolic resection for Crohn's disease.

methodsSurgical recurrence rates were compared between two cohorts. Cohort A [n = 30] underwent conventional ileocolic resection where the mesentery was divided flush with the intestine. Cohort B [n = 34] underwent resection which included excision of the mesentery. The relationship between mesenteric disease severity and surgical recurrence was determined in a separate cohort [n = 94]. A mesenteric disease activity index was developed to quantify disease severity. This was correlated with the Crohn's disease activity index and the fibrocyte percentage in circulating white cells.

resultsCumulative reoperation rates were 40% and 2.9% in cohorts A and B [P = 0.003], respectively. Surgical technique was an independent determinant of outcome [P = 0.007]. Length of resected intestine was shorter in cohort B, whilst lymph node yield was higher [12.25 ± 13 versus 2.4 ± 2.9, P = 0.002]. Advanced mesenteric disease predicted increased surgical recurrence [Hazard Ratio 4.7, 95% Confidence Interval: 1.71-13.01, P = 0.003]. The mesenteric disease activity index correlated with the mucosal disease activity index [r = 0.76, p < 0.0001] and the Crohn's disease activity index [r = 0.70, p < 0.0001]. The mesenteric disease activity index was significantly worse in smokers and correlated with increases in circulating fibrocytes.

conclusionsInclusion of mesentery in ileocolic resection for Crohn's disease is associated with reduced recurrence requiring reoperation.

Indexed as

ColectomyCrohn DiseaseMesenteryPeritoneal DiseasesReoperationAdultCohort StudiesColonDissectionFemaleHumansIleumIrelandMaleMiddle AgedOutcome and Process Assessment, Health Care

Identifiers

PMID29309546
PMCPMC6225977
OpenAlexW2888121871

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.