Long-term comparative outcomes after ileocecal resection for inflammatory versus complicated Crohn’s disease. A multicenter, retrospective study (Crohn's-Urg)
Bibliographic record
Abstract
BACKGROUND: Surgical intervention in Crohn's disease (CD) is often reserved for complications or failure of medical therapy. However, the benefits of early ileocecal resection for inflammatory phenotype (ICR) in patients with uncomplicated disease remain debated, particularly regarding long-term outcomes compared with complicated cases. METHODS: This international, multicenter, retrospective cohort study evaluated long-term outcomes of ICR in patients with inflammatory (uncomplicated) and complicated CD phenotypes. Data from 2013 patients (291 with uncomplicated CD) who underwent surgery between 2012 and 2022 were analyzed. The primary endpoint was endoscopic disease recurrence, with secondary outcomes including clinical and surgical recurrence, fecal calprotectin levels, and risk factors for recurrence. Statistical analyses included Kaplan-Meier survival estimates, Cox regression, and multivariable modeling. RESULTS: Complicated CD patients had higher rates of preoperative anemia, emergent surgery, and open procedures. Despite these differences, long-term endoscopic (HR: 1.03; p = 0.748), clinical (HR: 1.35; p = 0.073), and surgical recurrence rates (HR: 0.77; p = 0.419) were comparable between groups. Protective factors for recurrence included laparoscopic surgery (HR: 0.74; p = 0.009) and postoperative prophylaxis (HR: 0.63; p < 0.0001), while preoperative anemia (HR: 1.52; p < 0.0001) and positive margins (HR: 1.36; p = 0.001) increased recurrence risk. CONCLUSION: Long-term outcomes of ICR are similar in inflammatory and complicated CD when appropriate surgical and medical management is applied. Optimizing perioperative care and mitigating modifiable risk factors may improve outcomes, supporting the role of surgery even in less complicated CD cases.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".