Crohn's & Colitis 360最新文献

{"title":"Evaluation of pharmacokinetic metrics and pharmacodynamic biomarkers associated with endoscopic healing in pediatric Crohn's disease patients treated with anti-tumor necrosis factor biologics.","authors":"Courtney Bartel, Tomoyuki Mizuno, Rebekah Karns, Kei Irie, Kimberly Jackson, Kimberly Lynch, Abigail Samuels, Jeffrey S Hyams, Brendan Boyle, Jacob A Kurowski, Shehzad Saeed, Joshua D Noe, Kelly Chun, Jane Yang, Lee A Denson, Phillip Minar","doi":"10.1093/crocol/otag088","DOIUrl":"10.1093/crocol/otag088","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) patients achieving deep remission, defined as clinical remission with endoscopic healing (EH), have a lower rate of CD-related adverse events. EH can be achieved with anti-tumor necrosis factor (TNF) dose optimizations directed by pharmacokinetic (PK) and pharmacodynamic (PD) biomarkers. The primary aim was to identify PK metrics and PD biomarker cut-points associated with EH.</p><p><strong>Methods: </strong>In this multicenter, cross-sectional study, we enrolled CD patients (age 1-22 years) who received an anti-TNF biologic (infliximab or adalimumab) for >6 months and underwent ileocolonoscopy. EH was defined as a simple endoscopic score-CD (SES-CD) < 3.</p><p><strong>Results: </strong>Eighty-seven patients were enrolled with EH found in 55.2%. Lower levels of novel biomarkers neutrophil CD64, monocyte CD64, and soluble CD64 were associated with EH with cut-points of <4.5 ratio (AUROC 0.76), <44.6 ratio (AUROC 0.67), and <15.9 ng/mL (AUROC 0.67), respectively. There was no difference in the mean trough concentrations of infliximab or adalimumab between EH and non-EH, but the median infliximab clearance was higher in non-EH (0.26 L/day) compared to EH (0.21 L/day, <i>P</i> = .02). In our infliximab multivariable model, slower infliximab clearance, lower platelet count, and higher serum albumin were strong predictors for EH (AUC 0.90).</p><p><strong>Conclusions: </strong>We identified novel PK and PD cut-points for biomarkers associated with EH, including infliximab clearance and the novel CD64 biomarkers. Furthermore, we developed a multivariable PK and PD model for EH that, following validation, could guide dose escalation (PK failures) or prompt a switch to an alternate advanced therapeutic for PD failures.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag088"},"PeriodicalIF":1.8,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confirming the association of ulcerative colitis with interstitial lung disease: a retrospective analysis of comorbid disease, demographics, and healthcare utilization.","authors":"Sneh Parekh, Landen Shane Burstiner, Kaitlyn Romero, Anvit Reddy, Gerardo Diaz Garcia, Atefeh Vaezi, Mehdi Mirsaeidi, Lauren Stemboroski, Marianny Sulbaran","doi":"10.1093/crocol/otag085","DOIUrl":"10.1093/crocol/otag085","url":null,"abstract":"<p><strong>Background: </strong>Interstitial lung disease (ILD) is a rare extraintestinal manifestation associated with inflammatory bowel disease (IBD). Limited information is available regarding the prevalence and risk factors of ILD in IBD. This study aimed to determine the association of ILD in Crohn's disease (CD) and ulcerative colitis (UC), while analyzing various contributory factors.</p><p><strong>Methods: </strong>A retrospective analysis of patient data at two major tertiary healthcare centers in the southeastern United States from 2012 to 2022 was conducted. Patient demographics, healthcare utilization patterns, and coexisting diagnoses of IBD and ILD were analyzed using comparative statistical analysis.</p><p><strong>Results: </strong>A total of 8865 IBD patients were included in the study, of which 408 (4.6%) had concomitant IBD and ILD. Patients with UC had a significantly higher prevalence of ILD compared to those with CD (<i>P</i> < .001). There were no statistically significant differences in demographics between UC-ILD and CD-ILD patients. There was a significant difference in prevalence between White patients and minority patients with IBD and any form of ILD (<i>P</i> < .001). Finally, individuals with IBD-ILD were significantly older, had a higher proportion of emergency department (ED) visits, had a higher proportion of hospitalizations, had a higher proportion of patients with steroid use, and had a lower proportion of patients with mesalamine prescribed (<i>P</i> < .001), compared with IBD-only patients.</p><p><strong>Conclusions: </strong>Our findings confirm the established literature that ILD is more associated with UC compared to CD, while providing new insight into demographic and healthcare utilization factors between CD-ILD and UC-ILD patients and between IBD-ILD compared to IBD-only patients.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag085"},"PeriodicalIF":1.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An adapted health system access framework for avoidable inflammatory bowel disease admissions: a scoping review.","authors":"Rachel L Hawkins, Kimberly Butler, Fiona C Sampson, Alan J Lobo, Daniel Hind","doi":"10.1093/crocol/otag083","DOIUrl":"10.1093/crocol/otag083","url":null,"abstract":"<p><strong>Background: </strong>Access to healthcare may be driving unplanned and potentially avoidable hospital admissions for people diagnosed with inflammatory bowel disease (IBD). Interventions to reduce unplanned and potentially avoidable admissions need to be developed based on a clear conceptual framework that identifies the system-level access barriers contributing to these admissions. This scoping review aimed to synthesize the health system components for reducing unplanned IBD admissions to develop a conceptual framework to guide future interventions for reducing unplanned admissions.</p><p><strong>Methods: </strong>A scoping review was conducted to identify literature exploring factors associated with unplanned IBD admissions and interventions to reduce IBD admissions. Literature published between January 2000 and October 2024 was identified from 4 electronic databases (Medline, Embase, CINAHL, and PubMed). A narrative synthesis presented the findings, guided by Candidacy Framework, to understand issues in healthcare access.</p><p><strong>Results and conclusions: </strong>Of 1980 records identified, 17 were included. Avoidable IBD admissions result from inequity across the patient journey through healthcare, specifically in access to: (1) earlier intervention during a flare, (2) specialist clinical advice about symptoms and psychosocial issues, (3) rapid access to outpatient care, (4) patient education, (5) systems that support self-management, (6) proactive care strategies, and (7) collaborative health professional working and referrals. Addressing service permeability (ease of using services) and local production of candidacy (patient-provider relationships and macro-structural conditions) are understood as most important for addressing avoidable unplanned IBD admissions. The Health System Access Framework is useful for understanding how services need to address patient care.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag083"},"PeriodicalIF":1.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induction-phase infliximab monitoring accelerates time to remission in pediatric IBD: a retrospective cohort study.","authors":"Nicholas Iovino, Samantha R Paglinco, Mahmoud Abdel-Rasoul, Megan McNicol, Brendan Boyle, Hilary K Michel, Ross M Maltz","doi":"10.1093/crocol/otag080","DOIUrl":"10.1093/crocol/otag080","url":null,"abstract":"<p><strong>Background: </strong>In pediatric inflammatory bowel disease (IBD), the optimal timing to begin therapeutic drug monitoring (TDM) of infliximab (IFX) is unclear. We hypothesized that TDM during induction of IFX improves clinical outcomes in children with IBD.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from an internal database at Nationwide Children's Hospital between January 1, 2020, and December 31, 2023. Pediatric IBD patients receiving IFX with induction-phase TDM (I-TDM) at Week 6 were compared to those with maintenance-phase TDM (M-TDM) at Week 14. Propensity score matching (PSM) was used for sex, disease, and age at IFX start. The primary outcome was time to clinical remission.</p><p><strong>Results: </strong>In total, 68 patients were matched from each group. The I-TDM group experienced a shorter median time to clinical remission (140 days [95% CI: 108, 167]) compared to the M-TDM group (203 days [95% CI: 167, 232]; <i>P</i> = .006). When adjusting for baseline variations, I-TDM remained independently associated with accelerated clinical remission (aHR = 1.68, 95% CI: 1.10, 2.55; <i>P</i> = .016). While time to therapeutic maintenance IFX levels was similar, post hoc analysis showed that 75% of patients in the I-TDM group achieved target levels in 134 days (95% CI: 114, 182) versus 183 days (95% CI: 153, 224) in the M-TDM group. There were no significant differences in long-term complications between the groups.</p><p><strong>Conclusions: </strong>Induction-phase TDM before the third infusion shortens the time to clinical remission, allowing for more prompt dose adjustments and improving patient outcomes. This approach warrants consideration in clinical practice for children with IBD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag080"},"PeriodicalIF":1.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability among Palestinian patients with inflammatory bowel disease: evaluation using the IBD Disk and identification of associated factors.","authors":"Ahmed Quraish, Ro'ya Khanfar, Karmil Kharouf, Sami Salous, Dala Quraish, Qusay Abdoh","doi":"10.1093/crocol/otag079","DOIUrl":"10.1093/crocol/otag079","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) can substantially impair daily functioning, yet disability prevalence and determinants remain underexplored in Palestine. This study aimed to assess the prevalence of IBD-related disability using the IBD Disk tool and to identify risk factors associated with high disability among Palestinian patients.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among patients with a confirmed diagnosis of Crohn's disease (CD) or ulcerative colitis for at least six months. Participants completed an Arabic translation of the IBD Disk prepared through forward-backward translation. Demographic, clinical, and lifestyle data were collected. Disability was defined as an IBD Disk total score >40. Logistic regression was used to identify factors independently associated with disability.</p><p><strong>Results: </strong>A total of 179 patients (59.2% CD, mean age 33.68 ± 12.27 years) participated. The prevalence of IBD-related disability was 58.1%, with a mean total IBD Disk score of 45.31 ± 23.20. Joint pain was the highest-scoring domain (6.06 ± 3.32), while sexual function scored lowest (2.46 ± 2.43). While azathioprine use (adjusted odds ratio [aOR] 0.421, 95% confidence interval [CI] 0.213-0.829, <i>P</i> = .012) was associated with lower disability, self-reported vitamin D deficiency in the preceding 3 months was associated with higher disability (aOR 2.932, 95% CI 1.066-8.060, <i>P</i> = .03). Among patients with CD, cigarettes smoked per day showed a weak positive correlation with IBD Disk scores.</p><p><strong>Conclusions: </strong>High disability was common among Palestinian patients with IBD. Self-reported vitamin D deficiency in the preceding 3 months was associated with higher odds of high disability, whereas azathioprine use was associated with lower odds. Cigarettes smoked per day showed a weak positive correlation with disability scores among patients with CD, but smoking status was not independently associated with high disability.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag079"},"PeriodicalIF":1.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective endoscopy reporting in inflammatory bowel disease: a trainee's guide.","authors":"Kofi Clarke, Matthew D Coates","doi":"10.1093/crocol/otag082","DOIUrl":"10.1093/crocol/otag082","url":null,"abstract":"","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag082"},"PeriodicalIF":1.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bowel urgency in ulcerative colitis is associated with clinical endpoints, health-related quality of life, and biomarkers: data from the etrasimod ELEVATE UC 52 trial.","authors":"Marla C Dubinsky, Erica R Cohen, Peter M Irving, Martina Goetsch, Krisztina Lazin, Abhishek Bhattacharjee, Gokul Pradeep, Peter Hur, Christina Cognata, Karolina Wosik, Remo Panaccione","doi":"10.1093/crocol/otag072","DOIUrl":"10.1093/crocol/otag072","url":null,"abstract":"<p><strong>Background: </strong>Bowel urgency (BU) is a disruptive ulcerative colitis (UC) symptom. Etrasimod, a sphingosine 1-phosphate (S1P)_1,4,5 receptor modulator, improved BU in the ELEVATE UC clinical program.</p><p><strong>Methods: </strong>We assessed associations between BU and efficacy endpoints, health-related quality of life (HRQoL), and biomarkers (Weeks 12 and 52) in patients receiving etrasimod in ELEVATE UC 52. A patient-reported numerical rating scale (NRS; 0-10; none to worst BU) assessed BU at baseline, Week 12, and Week 52. Binary BU outcomes were BU remission (NRS ≤1), clinically meaningful improvement in BU (NRS ≥3-point decrease), and complete BU remission (NRS = 0).</p><p><strong>Results: </strong>At Week 12, etrasimod-treated patients with BU remission were 4.0 times more likely to be in clinical remission (odds ratio [95% confidence interval (CI)]: 4.0 [2.3-7.1]; <i>P </i>< .0001) and 3.6 times more likely to show endoscopic improvement (3.6 [2.1-6.2]; <i>P </i>< .0001) versus patients without BU remission. Patients with BU remission also had significantly greater improvement in Inflammatory Bowel Disease Questionnaire: Total score (least squares mean difference [95% CI] 21.8 [13.5-30.1], <i>P </i>< .0001) and significantly lower fecal calprotectin and high-sensitivity C-reactive protein (mean [standard deviation] 744.5 [1,758.0] vs 2,314.2 [5,182.2] and 3.2 [5.8] vs 10.5 [24.9], respectively, both <i>P </i>< .0001). A similar association was seen for clinically meaningful improvement in BU and complete BU remission at Week 12 and all BU outcomes at Week 52.</p><p><strong>Conclusions: </strong>In etrasimod-treated patients, bowel urgency outcomes are positively associated with efficacy endpoints, HRQoL scores, and inflammatory biomarkers, and may be surrogate markers of disease activity and HRQoL improvement.</p><p><strong>Clinicaltrialsgov: </strong>NCT03945188.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag072"},"PeriodicalIF":1.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition management and self-perceived relapse triggers in patients with inflammatory bowel disease: results from the 3R web-based survey.","authors":"Motohiro Esaki, Takayuki Matsumoto, Fumihito Hirai, Takahiro Suzuki, Yoshiyuki Hosoi, Akira Oota, Masaaki Higashikawa, Minami Umeyama, Masato Ueno","doi":"10.1093/crocol/otag081","DOIUrl":"10.1093/crocol/otag081","url":null,"abstract":"<p><strong>Background and aims: </strong>Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), requires long-term management. Besides pharmacotherapy, nutritional care is considered to be important; however, its real-world status in Japan remains unclear.</p><p><strong>Methods: </strong>In this study, a web-based survey on 150 patients with IBD (CD, 75; UC, 75) was conducted between October 30 and November 4, 2025. Patient demographics, self-perceived relapse frequency, self-perceived relapse triggers, implementation of nutritional therapy, and the use of health management apps were evaluated.</p><p><strong>Results: </strong>Patients with CD reported a higher self-perceived relapse frequency than did patients with UC (≥1 episode/year: 52% vs 32%) and were more likely to perceive diet as a self-perceived relapse trigger (77% vs 39%). Nutritional therapy was introduced in 53% of patients with CD and 12% of patients with UC, and 31% of patients with CD were currently using elemental diets. Most patients consumed 300-900 kcal/day, and some reported symptom improvement, although discontinuation was often due to the physician's decision or difficulty in intake. Dietary management awareness was higher in the CD group than in the UC group (77% vs 48%), whereas supplement use showed no significant difference (37% vs 29%). Health app usage was <10%, with common reasons for nonuse being a lack of awareness and perceived necessity.</p><p><strong>Conclusions: </strong>Nutritional therapy is more frequently administered to patients with CD in Japan, suggesting its clinical relevance. Strategies are required to enhance dietary guidance, support the continued use of elemental diets, and promote digital health tools.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag081"},"PeriodicalIF":1.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pediatric versus adult diagnosed inflammatory bowel disease on achievement of health care autonomy in emerging adults: a cross-sectional study.","authors":"Allison Bihari, Cynthia H Seow, Eytan Wine, Karen Goodman, Farhad Peerani, Frank Hoentjen, Lilian Du, Karen Wong, Brendan Halloran, Michal Gozdzik, Karen I Kroeker","doi":"10.1093/crocol/otag078","DOIUrl":"10.1093/crocol/otag078","url":null,"abstract":"<p><strong>Introduction: </strong>Emerging adulthood (ages 18-25) involves significant changes, made more challenging for those with inflammatory bowel disease (IBD), especially when transitioning from pediatric to adult care. Research has focused on transition readiness, with less attention to patient-prioritized outcomes after transfer. Less is also known about those diagnosed during emerging adulthood, who must navigate a new diagnosis and disease management. This study estimated the prevalence of behaviors reflecting health care autonomy among emerging adults with IBD, comparing pediatric- and adult-diagnosed cases.</p><p><strong>Methods: </strong>In this cross-sectional study, emerging adults with IBD in Alberta, Canada completed a questionnaire assessing IBD knowledge, self-management, relationship with their IBD care team, and disease management. Participants were grouped as pediatric-diagnosed (<18 years) or adult-diagnosed (18-25 years). Descriptive and comparative analyses were conducted.</p><p><strong>Results: </strong>Among 178 participants (122 pediatric-diagnosed; 56 adult-diagnosed), pediatric-diagnosed cases were younger on average than adult-diagnosed cases (21.0 vs. 22.2 years), with similar distributions of gender, ethnicity and disease type. IBD knowledge scores, relationship ratings, and medication adherence scores were similar between groups. Pediatric-diagnosed cases were less independent than adult-diagnosed cases in some self-management tasks, including scheduling visits (72.6% vs. 92.9%), contacting their care team (76.0% vs. 94.6%), calling in medication refills (75.5% vs. 90.7%), and preparing questions for providers (63.3% vs. 79.3%).</p><p><strong>Conclusion: </strong>Pediatric-diagnosed cases demonstrated similar IBD knowledge, medication adherence, and satisfaction with their care team, but were less independent in some self-management tasks compared to adult-diagnosed cases. These findings highlight the need for targeted education and support for emerging adults with IBD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag078"},"PeriodicalIF":1.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ileocecal resection for primary Crohn's disease: a 17-year experience from a tertiary care hospital in North Africa.","authors":"Souhaib Atri, Mahdi Hammami, Ahmed Ben Mahmoud, Amine Sebai, Houcine Maghrebi, Wael Rebai, Youssef Chaker, Amine Makni, Amine Daghfous, Rachid Ksantini, Mohamed Jouini, Anis Haddad, Montassar Kacem","doi":"10.1093/crocol/otag077","DOIUrl":"10.1093/crocol/otag077","url":null,"abstract":"<p><strong>Introduction: </strong>Ileocecal resection (ICR) is the most common procedure for primary Crohn's disease. While outcomes of ICR have been extensively studied in Europe and North America, data from North Africa remains scarce. This study reports a 17-year Tunisian experience, evaluating the feasibility of laparoscopic ICR in a low-income country in comparison to open surgery.</p><p><strong>Methods: </strong>This retrospective, single-center study reviewed patients who underwent ICR for histologically confirmed Crohn's disease between 2004 and 2020. Postoperative outcomes of laparoscopic and open approaches were compared. The endpoint was postoperative morbidity and mortality, intraoperative parameters, and recovery metrics.</p><p><strong>Results: </strong>A total of 336 patients underwent surgery for non-recurrent ileocecal Crohn's disease, with laparoscopic resection performed in 80% of cases. Conversion to open surgery occurred in 14.9%, mainly due to hemorrhagic dissection. Postoperative complications occurred in 9.2% of patients, with anastomotic leakage being the most frequent surgical issue. Medical complications were rare (1.2%). Laparoscopy was associated with faster recovery, shorter hospital stays, and lower analgesic requirements, although complication rates were not significantly different. The only significant predictor of anastomotic fistula was low body mass index (BMI) (<i>P</i> < .001). Postoperative mortality was 0.5%.</p><p><strong>Conclusion: </strong>In low-income countries, including North Africa, access to laparoscopy has expanded, with outcomes such as conversion rates and operative times approaching international standards. In our 17-year Tunisian experience, laparoscopic ICR proved feasible, reproducible, and safe. These findings contribute to the limited regional evidence and support the broader adoption of laparoscopy as the preferred surgical approach for Crohn's disease.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag077"},"PeriodicalIF":1.8,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}