Evidence map›Paper›PMID 37978997›Full record

ArticleInternational journal of colorectal disease2023

Extended versus limited mesenteric excision for operative Crohn's disease: 30-Day outcomes from the ACS-NSQIP database.

Shafic Abdulkarim, Ebram Salama, Allison J Pang, Nancy Morin, Gabriela Ghitulescu, Julio Faria, Carol-Ann Vasilevsky, Marylise Boutros

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In one paragraph

Article in International journal of colorectal disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 5 pooled it
1.9field-weighted citation impact, top 12% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 5 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Shafic AbdulkarimDepartment of Surgery, McGill University, Jewish General Hospital, 3755 Cote Ste Catherine, G-317, Montreal, QC, Canada. Shafic.abdulkarim@mail.mcgill.ca.
Ebram SalamaDepartment of Surgery, McGill University, Jewish General Hospital, 3755 Cote Ste Catherine, G-317, Montreal, QC, Canada.
Allison J PangDepartment of Surgery, McGill University, Jewish General Hospital, 3755 Cote Ste Catherine, G-317, Montreal, QC, Canada.
Nancy MorinDepartment of Surgery, McGill University, Jewish General Hospital, 3755 Cote Ste Catherine, G-317, Montreal, QC, Canada.
Gabriela GhitulescuDepartment of Surgery, McGill University, Jewish General Hospital, 3755 Cote Ste Catherine, G-317, Montreal, QC, Canada.
Julio FariaDepartment of Surgery, McGill University, Jewish General Hospital, 3755 Cote Ste Catherine, G-317, Montreal, QC, Canada.
Carol-Ann VasilevskyDepartment of Surgery, McGill University, Jewish General Hospital, 3755 Cote Ste Catherine, G-317, Montreal, QC, Canada.
Marylise BoutrosDepartment of Surgery, McGill University, Jewish General Hospital, 3755 Cote Ste Catherine, G-317, Montreal, QC, Canada.
McGill University · CAJewish General Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRecent studies have suggested that extended mesenteric excision (ME) may reduce surgical reintervention in Crohn's Disease (CD), but there remains clinical concerns regarding potential peri-operative morbidity. This retrospective study compares 30-day perioperative morbidity between limited and extended ME in segmental colectomies for CD.

methodsUsing the American College of Surgeons National Surgical Quality Improvement (ACS-NSQIP) colectomy-specific database, all patients with CD undergoing segmental colectomy for non-malignant indications between 2014-2019 were included. A lymph node harvest of 12 or more nodes was used as a surrogate for extended ME. The primary outcome was NSQIP major morbidity. Secondary outcomes included abdominal complications and perioperative bleeding.

resultsOf 3,709 patients included from the ACS-NSQIP database, 3,087 underwent limited ME and 622 underwent extended ME. On univariate analysis, those with limited mesenteric excision were less likely to be anemic (46.1% vs 55.0%, p < 0.001) and have undergone an open surgery (44.7% vs 34.7%, p < 0.001). On univariate comparison of limited and extended ME, there was no significant difference in major morbidity. On multiple logistic regression, controlling for age, sex, BMI, smoking, preoperative sepsis, preoperative anemia, surgical approach, emergency surgery, stoma creation, bowel preparation, and immunosuppression, the extent of ME was not an independent predictor of NSQIP major morbidity (OR 1.1, 95% CI 0.84-1.44). Likewise, the extent of ME was not associated with an increase in abdominal complications (OR 0.95, 95% CI 0.76-1.19) or post-operative bleeding (OR 1.89, 95% CI 0.75-1.53).

conclusionExtended ME for CD was not associated with an increase in 30-day perioperative major morbidity.

Indexed as

Crohn DiseaseColectomyHumansPostoperative ComplicationsQuality ImprovementRetrospective StudiesColorectal surgeryCrohn’s diseaseExtended mesenteric excisionMesenteric resection

Identifiers

PMID37978997
OpenAlexW4388797887

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.