ArticleGastroenterology2023
Early Ileocecal Resection for Crohn's Disease Is Associated With Improved Long-term Outcomes Compared With Anti-Tumor Necrosis Factor Therapy: A Population-Based Cohort Study.
Article in Gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 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
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Online information on bowel resection for Crohn's disease.Annals of the Royal College of Surgeons of England · 2026Pooled it
- EARLY ILEOCECAL RESECTION IN CROHN'S DISEASE: A SYSTEMATIC REVIEW.Arquivos de gastroenterologia · 2026Pooled it
- Refractory Chronic Inflammatory Bowel Disease in Childhood and Adolescence: Options in Primary Non-Response or Secondary Treatment Failure.Deutsches Arzteblatt international · 2026Review
- 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
- Addressing real-world data gaps: estimating the uk population cost of crohn's disease and ulcerative colitis using a flexible cost-of-illness model informed by the optimal patient journey and IBDUK patient survey 2023.BMC health services research · 2026Article
- The prognostic role of magnetic resonance enterography at diagnosis in paediatric isolated ileocaecal Crohn's disease.Journal of pediatric gastroenterology and nutrition · 2026Article
- Benefits of Surgical Management in Ileocecal Crohn's Disease: A Review of the Past Decade (2020-2026).Medicina (Kaunas, Lithuania) · 2026Review
- Timing of ileocolic resection for Crohn's disease: A survey of the patient perspective in the 'biological' era.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Article
- Treatment-Free Outcomes Following Surgery for IBD: A Nationwide Cohort Study.Alimentary pharmacology & therapeutics · 2026Article
- Phenotype-driven management in ileocecal Crohn's disease: a narrative review with a proposed research framework.Therapeutic advances in gastroenterology · 2026Review
- Efficacy of Advanced Therapies as Prophylaxis and for Active Disease in Postoperative Crohn's Disease: A Comprehensive Review.Journal of clinical medicine · 2025Review
- Multi-Omics Analysis of Ileal Mucosa and Mesentery Before and After Ileocecal Resection in Crohn's Disease.United European gastroenterology journal · 2025Article
- Temporal trends in surgical treatment of inflammatory bowel disease following introduction of biological drugs in Norway and Sweden.BMJ open gastroenterology · 2025Article
- Epidemiology of Elderly Onset IBD: A Nationwide Population-Based Cohort Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2025Article
- Substantial Reduction of Systemic Corticosteroid Use After Primary Ileocaecal Resection in Swedish Patients With Crohn's Disease: A Population-Based Cohort Study.Alimentary pharmacology & therapeutics · 2025Article
- Inflammatory bowel disease in south Asia: a scoping review.The lancet. Gastroenterology & hepatology · 2025Article
- Management of Uncomplicated Luminal Crohn's Disease.Gastroenterology & hepatology · 2025Article
- The challenges of implementing earlier surgery for terminal ileal Crohn's disease-A qualitative study of the clinician's perspective.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
- [An update on surgical treatment options for inflammatory bowel disease].Innere Medizin (Heidelberg, Germany) · 2025Review
- Early Surgical Resection in Pediatric Patients with Localized Ileo-Cecal Crohn's Disease: Results of a Retrospective Multicenter Study.Journal of clinical medicine · 2025Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsEarly Crohn's disease (CD) treatment involves anti-tumor necrosis factor (TNF) agents, whereas ileocecal resection (ICR) is reserved for complicated CD or treatment failure. We compared long-term outcomes of primary ICR and anti-TNF therapy for ileocecal CD.
methodsUsing cross-linked nationwide registers, we identified all individuals diagnosed with ileal or ileocecal CD between 2003 and 2018 and treated with ICR or anti-TNF agents within 1 year of diagnosis. The primary outcome was a composite of ≥1 of the following: CD-related hospitalization, systemic corticosteroid exposure, CD-related surgery, and perianal CD. We conducted adjusted Cox's proportional hazards regression analyses and determined the cumulative risk of different treatments after primary ICR or anti-TNF therapy.
resultsOf 16,443 individuals diagnosed with CD, 1279 individuals fulfilled the inclusion criteria. Of these, 45.4% underwent ICR and 54.6% received anti-TNF. The composite outcome occurred in 273 individuals (incidence rate, 110/1000 person-years) in the ICR group and in 318 individuals (incidence rate, 202/1000 person-years) in the anti-TNF group. The risk of the composite outcome was 33% lower with ICR compared with anti-TNF (adjusted hazard ratio, 0.67; 95% confidence interval, 0.54-0.83). ICR was associated with reduced risk of systemic corticosteroid exposure and CD-related surgery, but not other secondary outcomes. The proportion of individuals on immunomodulator, anti-TNF, who underwent subsequent resection, or were on no therapy 5 years post-ICR was 46.3%, 16.8%, 1.8%, and 49.7%, respectively.
conclusionThese data suggest that ICR may have a role as first-line therapy in CD management and challenge the current paradigm of reserving surgery for complicated CD refractory or intolerant to medications. Yet, given inherent biases associated with observational data, our findings should be interpreted and applied cautiously in clinical decision making.
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.