ArticleJournal of Crohn's & colitis2019
Persistent Mesorectal Inflammatory Activity is Associated With Complications After Proctectomy in Crohn's Disease.
Article in Journal of Crohn's & colitis, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- To cut or not to cut? Extended mesenteric excision during intestinal resection does not impact the postoperative recurrence nor the postoperative complications in Crohn's disease: a systematic review and meta-analysis.Techniques in coloproctology · 2025Pooled it
- Meta-analysis of early bowel resection versus initial medical therapy in patient's with ileocolonic Crohn's disease.International journal of colorectal disease · 2020Pooled it
- When nothing else matters: proctectomy for complex perianal Crohn's disease-indications, timing, techniques, and outcomes.Techniques in coloproctology · 2026Review
- Surgical management of metastatic cutaneous Crohn's disease: a case series from a tertiary centre in the United Kingdom.Techniques in coloproctology · 2026Article
- 10 Strategies for prevention of perineal wound dehiscence after intersphincteric proctectomy for perianal Crohn's disease.Techniques in coloproctology · 2026Review
- Mesenteric inclusion in Crohn's disease surgery: Promising breakthrough or tempest in a teapot? An updated meta-analysis.Surgery open science · 2025Review
- Long-term perineal wound healing and re-operation rates after proctectomy in patients with inflammatory bowel disease-A retrospective multicentre study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
- Local Pedicled Flaps and Biological Implant Options for Patients Undergoing Proctectomy for Crohn's Disease When an Omental Pedicle Flap Is Not Possible.Medicina (Kaunas, Lithuania) · 2025Article
- Long-Term Complications of Proctectomy for Refractory Perianal Crohn's Disease: A Narrative Review.Journal of clinical medicine · 2025Review
- The Surgical Management of the Mesentery in Crohn's Disease.Clinics in colon and rectal surgery · 2025Review
- Management and Treatment of Perianal Fistulizing Crohn's Disease.Clinical and experimental gastroenterology · 2025Review
- Surgical treatment of inflammatory bowel disease: From the gastroenterologist's stand-point.World journal of gastrointestinal surgery · 2024Article
- Extended versus limited mesenteric excision for operative Crohn's disease: 30-Day outcomes from the ACS-NSQIP database.International journal of colorectal disease · 2023Article
- Proposal of novel staging system CNM (Crohn's primary site, nodes, mesentery) to predict postoperative recurrence of Crohn's disease.Intestinal research · 2023Article
- Perioperative optimization of Crohn's disease.Annals of gastroenterological surgery · 2023Review
- Intriguing Role of the Mesentery in Ileocolic Crohn's Disease.Clinics in colon and rectal surgery · 2022Review
- Role of the Mesentery in Crohn's Terminal Ileitis.Clinics in colon and rectal surgery · 2022Review
- Has the Removing of the Mesentery during Ileo-Colic Resection an Impact on Post-Operative Complications and Recurrence in Crohn's Disease? Results from the Resection of the Mesentery Study (Remedy).Journal of clinical medicine · 2022Article
- Article
- Surgical management of Crohn's disease: a state of the art review.International journal of colorectal disease · 2021Review
Corrections and comments
- Commented on by
- Comment on
Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsRectal resection in inflammatory bowel disease [IBD] is frequently complicated by disturbed perineal wound healing. Close rectal dissection, where the mesorectum remains in situ, is hypothesized to reduce complications by minimizing dead space, compared to total mesorectal excision. The aim of this study was to analyse post-operative outcomes of both techniques. In addition, immune activity in mesorectal tissue was assessed.
methodsPerineal complications and healing were retrospectively assessed in a series of 74 IBD patients undergoing proctectomy using close rectal dissection or total mesorectal excision. The mesorectums of 15 patients were analysed by fluorescence-activated cell sorting, immunofluorescence and in situ hybridization. Based on the clinical and in vitro findings, a novel surgical approach for Crohn's disease patients with disturbed perineal healing after proctectomy was developed.
resultsIn Crohn's disease, perineal complications were more frequent after close rectal dissection than after total mesorectal excision [59.5% vs 17.6%; p = 0.007] with lower healing rates [51.4% vs 88.2%; p = 0.014]. No differences were observed in ulcerative colitis. The mesorectal tissue in Crohn's disease contained enhanced numbers of tumour necrosis factor α-producing CD14+ macrophages, with less expression of the wound-healing marker CD206. Based on these findings, mesorectal excision with omentoplasty was performed in eight patients with perineal complications after close rectal dissection, resulting in complete perineal wound closure in six. Pro-inflammatory characteristics remained present in the mesorectum after close rectal dissection in these patients.
conclusionsIn Crohn's disease, close rectal dissection resulted in more perineal complications, associated with a pro-inflammatory immune status of the mesorectal tissue. Excision of this pro-inflammatory mesenteric tissue resulted in improved perineal healing rates.
Indexed as
Identifiers
What OpenQuestion holds
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.