SynthesisInternational journal of colorectal disease2020
Meta-analysis of early bowel resection versus initial medical therapy in patient's with ileocolonic Crohn's disease.
Synthesis in International journal of colorectal disease, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
What it found
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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.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- TL1A as a therapeutic renaissance in inflammatory bowel disease: a systematic review from molecular mechanisms to clinical translation.Journal of Crohn's & colitis · 2026Pooled it
- Effect of extensive mesenteric excision on primary ileocolic resection outcomes in Crohn's disease patients: a systematic review with meta-analysis.International journal of colorectal disease · 2025Pooled it
- Surgical features to reduce anastomotic recurrence of Crohn's disease that requires reoperation: a systematic review.Surgery today · 2022Pooled it
- Complication Profiles following Right-Sided Segmental Colectomy: A Comparative Retrospective Analysis of Crohn's Disease and Colon Cancer.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2026Article
- Management of Crohn's Disease in Adult Patients: A Contemporary Surgical Perspective.Biomedicines · 2026Review
- Mesenteric excision and Kono-S anastomosis trial (MEErKAT): A study protocol for a multicentre, 2 × 2 factorial, randomised controlled, open-label superiority trial.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
- Understanding the therapeutic toolkit for inflammatory bowel disease.Nature reviews. Gastroenterology & hepatology · 2025Review
- The patient and clinician perspective on 'early' bowel resection for terminal ileal Crohn's disease (EBRIC): protocol for a multicentre mixed-methods study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
- Surgical and non-surgical risk factors affecting the insufficiency of ileocolic anastomosis after first-time surgery in Crohn's disease patients.World journal of gastrointestinal surgery · 2024Article
- Essential updates 2020/2021: Colorectal diseases (benign)-Current topics in the surgical and medical treatment of benign colorectal diseases.Annals of gastroenterological surgery · 2022Review
- [Terminal ileitis in Crohn's disease-Is primary surgery the better treatment?]Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021Review
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly bowel resection (EBR) in ileocolonic Crohn's disease (CD) may be associated with more durable remission compared with initial medical therapy (IMT) even when biologic therapy is included.
aimTo compare the efficacy of EBR versus IMT for ileocolonic CD
methodsA systematic search was performed to identify studies that compared EBR (performed < 1 year from initial diagnosis) or IMT for the management of ileocolonic CD. Log hazard ratios (InHR) for relapse-free survival (RFS) and their standard errors were calculated from Kaplan-Meier plots and pooled using the inverse-variance method. Dichotomous variables were pooled as odds ratios (OR). Quality assessment of the included studies was performed using the Newcastle-Ottawa (NOS) and Jadad scales.
resultsA total of 7 studies with 1863 CD patients (EBR n = 581, 31.2%; IMT n = 1282, 68.8%) were eligible for inclusion. There was a moderate-to-high risk of bias. The median NOS was 8 (range 7-9). There was a reduced likelihood of overall (OR, 0.53; 95% confidence interval (95% CI), 0.34, 0.83; p = 0.005) and surgical (OR, 0.47; 95% CI, 0.24, 0.91; p = 0.03) relapse with EBR. There was also a less requirement for maintenance biologic therapy (OR, 0.24; 95% CI, 0.14, 0.42; p < 0.0001). Patients who underwent EBR had a significantly improved RFS than those who underwent IMT (HR, 0.62; 95% CI, 0.52, 0.73; p < 0.001). There was no difference in morbidity (OR, 1.67; 95% CI, 0.44, 6.36; p = 0.45) between the groups.
conclusionEBR may be associated with less relapse and need for maintenance biologic therapy than IMT. 'Upfront' or early resection may represent a reasonable and cost-effective alternative to biologic therapy, especially in biologic-resistant subpopulations.
trial registration
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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.