Intestinal Research

Review

Tumor

Comparison between endoscopic resection and transanal surgery for treatment of rectal tumors: a systematic review and meta‑analysis: Chan Hyuk Park, Byung Wook Jung, Yoon Suk Jung; Intest Res 2026;24(1):38-51. Published online December 5, 2025; DOI: https://doi.org/10.5217/ir.2025.00180

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Background/Aims
Both endoscopic resection (ER) and transanal surgery (TAS) are minimally invasive treatment options that allow organ preservation in early rectal tumors. We conducted a meta-analysis to compare treatment outcomes between the 2 treatments.
Methods
We searched all relevant studies published until January 2024 that examined the comparative outcomes between ER and TAS for rectal tumors, including adenoma, adenocarcinoma, and neuroendocrine tumor (NET). TAS included transanal excision, transanal endoscopic microsurgery, and transanal minimally invasive surgery.
Results
Seventeen studies with a total of 1,569 patients were included in this meta-analysis. For adenoma/adenocarcinoma, the R0 resection rate did not differ between ER and TAS (risk ratio [RR], 0.99; 95% confidence interval [CI], 0.94–1.03). For NET, the R0 resection rate was lower in the ER group than in the TAS group (RR, 0.76; 95% CI, 0.68–0.84) and the procedure time for ER was shorter than that for TAS. For both adenoma/adenocarcinoma and NET, ER and TAS did not differ in terms of complication rates, additional surgery, and recurrence.
Conclusions
ER and TAS showed similar treatment outcomes for adenoma/adenocarcinoma. Considering that TAS typically incurs higher costs than ER, ER may be favored in the treatment of rectal adenoma/adenocarcinoma. For rectal NET, TAS showed a superior R0 resection rate than ER. However, given that TAS requires a long procedure time, expensive equipment, and complex manipulations, TAS may be considered selectively for large NETs with suspected deep tumorous infiltration.

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Endoscopic Resection of Rectal Neuroendocrine Tumors: Pathologic Risk Stratification and Surveillance Strategies
Ji Eun Kim
Journal of Digestive Cancer Research.2025; 13(3): 228. CrossRef

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Original Articles

Evolution of surgical trends in Crohn’s disease during the biologic era: population-based cohort insights from Taiwan, a low-endemicity region: Er-Hsiang Yang, Nai-Yu Chen, Ching-Lan Cheng, Yu-Ching Chang, Po-Chuan Chen, Lu-Hsuan Wu, Jui-Wen Kang, Hsueh-Chien Chiang, Po-Jun Chen, Bo-Wen Lin, Hsin-Yu Kuo, Chiao-Hsiung Chuang; Received January 10, 2025 Accepted August 21, 2025 Published online November 25, 2025; DOI: https://doi.org/10.5217/ir.2025.00003 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Surgery remains a crucial treatment option for Crohn’s disease (CD), even with the introduction of biological agents. This nationwide cohort study in Taiwan investigates surgery trends and the impacts of biologics in a region with a low prevalence of CD.
Methods
This retrospective population-based cohort study used Taiwan’s National Health Insurance Database from 2003 to 2018. The cohort included 725 CD patients. Patient characteristics, surgery outcomes, and impact of the biologic era on surgical risk were analyzed.
Results
During the study period, 292 CD patients (40.3%) underwent surgery, with 125 in the pre-biologic era and 167 in the post-biologic era. The incidences of intestinal surgery (IS) and perianal surgery (PS) have significantly decreased. The cumulative probabilities of IS were 20%, 35%, and 44% after 1, 5, and 10 years, respectively; the PS incidences were 3%, 5%, and 7%, respectively. The cumulative incidence of IS was significantly lower in the post-biologic era compared to the pre-biologic era (P= 0.049). CD patients had high second IS incidences of 31% at 5 years after the first IS.
Conclusions
Our study demonstrates the surgical incidences have decreased in the biologic era but remained relatively high in a region with low disease prevalence. This suggests the need for further improvements in CD management.

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IBD

Characteristics and long-term outcomes of children with perianal Crohn’s disease: Ching-Chun Lin, Ichiro Takeuchi, Hirotaka Shimizu, Reiko Kyodo, Mitsuru Kubota, Akira Ishiguro, Katsuhiro Arai; Intest Res 2026;24(1):164-173. Published online March 5, 2025; DOI: https://doi.org/10.5217/ir.2024.00154

Abstract PDF PubReader ePub

Background/Aims
The incidence of perianal lesions (PL) in children with Crohn’s disease (CD) is higher in East Asia than in Western countries. Early intervention for PL is essential to prevent sphincter dysfunction and ostomy placement. In this study, we aimed to investigate the clinical features, treatment, and consequences of pediatric CD with PL.
Methods
We retrospectively reviewed a cohort of children diagnosed with CD from 2010 to 2020 at a Japanese children’s hospital. Demographics, treatments, and outcomes were evaluated and compared among subgroups.
Results
Among 112 pediatric patients with CD, 36 (32.1%) had experienced PL during the observational period. The median ages at diagnosis and follow-up periods were 131 and 70 months, respectively. Six (85.7%) patients in the very early-onset (VEO) group (CD diagnosed before 6 years old) and 24 (82.8%) in the older age group had PL upon diagnosis of CD (P= 0.851). Biologics were given to 94.4% of patients: infliximab (67.7%), adalimumab (58.8%), ustekinumab (44.1%), risankizumab (11.8%), and vedolizumab (5.9%). Biologics were introduced within 1 year in 89.5% and 40.0% of patients diagnosed in 2016–2020 and 2010–2016, respectively (P= 0.002). Seton was frequently used in the older age group (87.5 vs. 42.9%, P= 0.190). Ostomy was frequently required in the VEO group (42.9% vs. 0.0%, P= 0.006).
Conclusions
Patients with VEO-CD and PL had a notably high risk of ostomy placement. The earlier introduction of biologics and surgical interventions reduced corticosteroids use and ostomy placement in pediatric CD patients with PL.

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Asian–Pacific perspectives on the management of very early-onset inflammatory bowel disease
Ichiro Takeuchi, Katsuhiro Arai, Pornthep Tanpowpong, Ming-Wei Lai, Andrew S Day, Way Seah Lee, James Guoxian Huang, Karen Sophia Calixto-Mercado, Rosanna Ming Sum Wong, Muhammad Arshad Alvi, Zubin Grover, Jung Ok Shim, Ujjal Poddar
Intestinal Research.2025; 23(4): 405. CrossRef

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IBD

Laparoscopic surgery contributes to a decrease in short-term complications in surgical ulcerative colitis patients during 2008–2017: a multicenter retrospective study in China: Zerong Cai, Xiaosheng He, Jianfeng Gong, Peng Du, Wenjian Meng, Wei Zhou, Jinbo Jiang, Bin Wu, Weitang Yuan, Qi Xue, Lianwen Yuan, Jinhai Wang, Jiandong Tai, Jie Liang, Weiming Zhu, Ping Lan, Xiaojian Wu; Intest Res 2023;21(2):235-243. Published online December 2, 2022; DOI: https://doi.org/10.5217/ir.2022.00012

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Background/Aims
The aim of this study was to analyze the chronological changes in postoperative complications in surgical ulcerative colitis patients over the past decade in China and to investigate the potential parameters that contributed to the changes.
Methods
Ulcerative colitis patients who underwent surgery during 2008–2017 were retrospectively enrolled from 13 hospitals in China. Postoperative complications were compared among different operation years. Risk factors for complications were identified by logistic regression analysis.
Results
A total of 446 surgical ulcerative colitis patients were analyzed. Fewer short-term complications (24.8% vs. 41.0%, P=0.001) and more laparoscopic surgeries (66.4% vs. 25.0%, P<0.001) were found among patients who received surgery during 2014–2017 than 2008–2013. Logistic regression suggested that independent protective factors against short-term complications were a higher preoperative body mass index (odds ratio [OR], 0.870; 95% confidence interval [CI], 0.785–0.964; P=0.008), laparoscopic surgery (OR, 0.391; 95% CI, 0.217–0.705; P=0.002) and elective surgery (OR, 0.213; 95% CI, 0.067–0.675; P=0.009). The chronological decrease in short-term complications was associated with an increase in laparoscopic surgery.
Conclusions
Our data revealed a downward trend of short-term postoperative complications among surgical ulcerative colitis patients in China during the past decade, which may be due to the promotion of minimally invasive techniques among Chinese surgeons.

Citations

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Surgical trend including minimally invasive surgeries for ulcerative colitis in the COSUC study: the largest multicenter cohort study in Japan
Koya Hida, Yoshiki Okita, Yusuke Fujii, Toru Miyake, Yoshiaki Kuriu, Yu Hidaka, Tomohiro Arita, Kiyotaka Kawaguchi, Shingo Ochi, Yusuke Fujita, Kazutaka Obama, Takeshi Naitoh, Nobuhisa Matsuhashi, Yudai Fukui, Shintaro Kohama, Manabu Takata, Shin Takesue,
Surgical Endoscopy.2025; 39(6): 3911. CrossRef
Surgical Options for Appropriate Length of J-Pouch Construction for Better Outcomes and Long-term Quality of Life in Patients with Ulcerative Colitis after Ileal Pouch-Anal Anastomosis
Weimin Xu, Wenbo Tang, Wenjun Ding, Zhebin Hua, Yaosheng Wang, Xiaolong Ge, Long Cui, Xiaojian Wu, Wei Zhou, Zhao Ding, Peng Du
Gut and Liver.2024; 18(1): 85. CrossRef
Time trend in surgical indications and outcomes in ulcerative colitis—A two decades in-depth retrospective analysis
Guillaume Le Cosquer, Lena Capirchio, Pauline Rivière, Marie Armelle Denis, Florian Poullenot, Christophe Remue, Frank Zerbib, Daniel Leonard, Bertrand Célérier, Alex Kartheuser, David Laharie, Olivier Dewit
Digestive and Liver Disease.2023; 55(10): 1338. CrossRef
Surgical Treatment in Ulcerative Colitis, Still Topical: A Narrative Review
Eduard Slonovschi, Pratyusha Kodela, Monalisa Okeke, Sandeep Guntuku, Shanmukh Sai Pavan Lingamsetty
Cureus.2023;[Epub] CrossRef
Surgical outcomes and stoma-related complications in inflammatory bowel disease in Saudi Arabia: a retrospective study
Thamer A. Bin Traiki, Sulaiman A. Alshammari, Mansoor A. Abdulla, Fayez G. Aldarsouni, Noura S. Alhassan, Maha-Hamdien Abdullah, Awadh Alqahtani, Khayal A. Alkhayal
Annals of Saudi Medicine.2023; 43(6): 386. CrossRef

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IBD

Factors associated with anti-tumor necrosis factor effectiveness to prevent postoperative recurrence in Crohn’s disease: Anthony Buisson, Lisa Cannon, Konstantin Umanskiy, Roger D. Hurst, Neil H. Hyman, Atsushi Sakuraba, Joel Pekow, Sushila Dalal, Russell D. Cohen, Bruno Pereira, David T. Rubin; Intest Res 2022;20(3):303-312. Published online August 4, 2021; DOI: https://doi.org/10.5217/ir.2021.00018

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
We assessed the effectiveness of anti-TNF agents and its associated factors to prevent endoscopic and clinical postoperative recurrence (POR) in Crohn’s disease (CD).
Methods
From a prospectively-maintained database, we retrieved 316 CD patients who underwent intestinal resection (2011–2017). Endoscopic (Rutgeerts index ≥ i2 at 6 months) and clinical (recurrence of symptoms leading to hospitalization or therapeutic escalation) POR were assessed.
Results
In 117 anti-TNF-naïve patients, anti-TNF therapy was more effective than immunosuppressive agents (odds ratio [OR], 8.8; 95% confidence interval [CI], 1.8–43.9; P= 0.008) and no medication/5-aminosalicylates (OR, 5.2; 95% CI, 1.0–27.9; P= 0.05) to prevent endoscopic POR. In 199 patients exposed to anti-TNF prior to the surgery, combination with anti-TNF and immunosuppressive agents was more effective than anti-TNF monotherapy (OR, 2.32; 95% CI, 1.02–5.31; P= 0.046) to prevent endoscopic POR. Primary failure to anti-TNF agent prior to surgery was predictive of anti-TNF failure to prevent endoscopic POR (OR, 2.41; 95% CI, 1.10–5.32; P= 0.03). When endoscopic POR despite anti-TNF prophylactic medication (n = 55), optimizing anti-TNF and adding an immunosuppressive drug was the most effective option to prevent clinical POR (hazard ratio, 7.38; 95% CI, 1.54–35.30; P= 0.012). Anti-TNF therapy was the best option to prevent clinical POR (hazard ratio, 3.10; 95% CI, 1.09–8.83; P= 0.034) in patients with endoscopic POR who did not receive any biologic to prevent endoscopic POR (n = 55).
Conclusions
Anti-TNF was the most effective medication to prevent endoscopic and clinical POR. Combination with anti-TNF and immunosuppressive agents should be considered in patients previously exposed to anti-TNF.

Citations

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Systematic review and network meta-analysis comparing the efficacy of conventional therapy and biologics to prevent endoscopic postoperative recurrence in patients with Crohn’s disease
Marianne Hupé, Bruno Pereira, Anthony Buisson
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Impact of age at diagnosis on long‐term prognosis in patients with intestinal Behçet's disease
Ji Young Chang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
Journal of Gastroenterology and Hepatology.2024; 39(3): 519. CrossRef
Postoperative small bowel Crohn's disease: how to diagnose, manage and treat
Chak Lam Ip, Ray Boyapati, Rahul Kalla
Current Opinion in Gastroenterology.2024; 40(3): 209. CrossRef
Stapled End-To-Side Ileocolic Anastomosis in Crohn’s Disease: Old Dog, Reliable Tricks? A Retrospective Two-Center Cohort Study
Volkan Doğru, Jean H. Ashburn, Umut Akova, Alton G. Sutter, Eren Esen, Emily M. Gardner, Andre da Luz Moreira, Arman Erkan, John Kirat, Michael J. Grieco, Feza H. Remzi
Annals of Surgery Open.2024; 5(1): e374. CrossRef
Clinical Significance of Prognostic Nutrition Index in Patients with Crohn’s Disease after Primary Bowel Resection
Hyeon Woo Bae, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Jae Hee Cheon, Joseph C. Carmichael, Byung Soh Min
Yonsei Medical Journal.2024; 65(7): 380. CrossRef
How Reliable Is Endoscopic Scoring of Postoperative Recurrence in Crohn Disease?: A Systematic Review and Meta-Analysis
Eline M. L. van der Does de Willebois, Vittoria Bellato, Marjolijn Duijvestein, Susan van Dieren, Silvio Danese, Pierpaolo Sileri, Christianne J. Buskens, Andrea Vignali, Willem A. Bemelman
Annals of Surgery Open.2024; 5(1): e397. CrossRef
Systematic review: Patient‐related, microbial, surgical, and histopathological risk factors for endoscopic post‐operative recurrence in patients with Crohn's disease
Michiel T. J. Bak, Karlijn Demers, Nassim Hammoudi, Matthieu Allez, Mark S. Silverberg, Gwenny M. Fuhler, Kaushal Parikh, Marieke J. Pierik, Laurents P. S. Stassen, C. Janneke van der Woude, Michail Doukas, Oddeke van Ruler, Annemarie C. de Vries
Alimentary Pharmacology & Therapeutics.2024; 60(3): 310. CrossRef
Common Mistakes in Managing Patients with Inflammatory Bowel Disease
Javier P. Gisbert, María Chaparro
Journal of Clinical Medicine.2024; 13(16): 4795. CrossRef
Preventing Recurrence of Crohn’s Disease Post-Ileocaecal Surgery in Paediatric Patients: A Therapy Guide Based on Systematic Review of the Evidence
Jiri Bronsky, Kristyna Zarubova, Michal Kubat, Vojtech Dotlacil
Pediatric Drugs.2024; 26(6): 659. CrossRef
Anti-TNF Agents and New Biological Agents (Vedolizumab and Ustekinumab) in the Prevention and Treatment of Postoperative Recurrence After Surgery in Crohn’s Disease
Javier P. Gisbert, María Chaparro
Drugs.2023; 83(13): 1179. CrossRef
Prevention of postoperative recurrence in Crohn’s disease: the never-ending story
Jung-Bin Park, Sang Hyoung Park
Intestinal Research.2022; 20(3): 279. CrossRef
Timing of individualized surgical intervention in Crohn’s disease
Kai Xia, Ren-Yuan Gao, Xiao-Cai Wu, Lu Yin, Chun-Qiu Chen
World Journal of Gastrointestinal Surgery.2022; 14(12): 1320. CrossRef

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Colorectal neoplasia

Clinical outcomes of submucosal colorectal cancer diagnosed after endoscopic resection: a focus on the need for surgery: Yun Sik Choi, Wan Soo Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon; Intest Res 2020;18(1):96-106. Published online January 30, 2020; DOI: https://doi.org/10.5217/ir.2019.00092

Abstract PDF PubReader ePub

Background/Aims
We aimed to investigate the proportion of and risk factors for residual cancer and/or lymph node metastasis after surgery was performed because of high-risk pathological features in endoscopic resection specimen of suspected superficial submucosal colorectal cancer (SSMC).
Methods
We reviewed medical records of 497 patients (58.8 ± 9.8 years, 331 males) undergoing endoscopic resection of suspected SSMC. High-risk pathological features included: deep submucosal cancer invasion ≥ 1,000 μm; positive lymphovascular and/or perineural invasion; poorly differentiated adenocarcinoma; and positive resection margin. We investigated the occurrence of additional surgery and residual cancer and/or lymph node involvement in the surgical specimen.
Results
En bloc resection was performed in 447 patients (89.9%). High-risk pathological features were detected in 372 patients (74.8%). Additional surgery was performed in 336 of 372 patients with high-risk pathological features. Of these, 47 surgical specimens (14.0%) showed residual cancer and/or lymph node metastasis. Piecemeal resection was more common in those with residual cancer and/or lymph node involvement than those without (9/47 [19.1%] vs. 24/289 [8.3%], P= 0.032). Positive resection margin was also significantly associated with positive residual cancer and/or lymph node involvement. As the number of high-risk pathological features increased, the risk of regional lymph node metastasis increased proportionally (P= 0.002).
Conclusions
High-risk pathological features were frequently detected after endoscopic resection of suspected SSMC while residual cancer and/or lymph node metastasis were not commonly present in the additional surgical specimen. Further optimized strategy for proper endoscopic management of suspected SSMC is necessary.

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Survey of the Actual Practices Used for Endoscopic Removal of Colon Polyps in Korea: A Comparison with the Current Guidelines
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong-Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, Eun R
Gut and Liver.2025; 19(1): 77. CrossRef
Salvageable locoregional recurrence and stoma rate after local excision of pT1-2 rectal cancer – a nationwide cross-sectional cohort study
L.R. Moolenaar, E.G.M. van Geffen, S.J.A. Hazen, T.C. Sluckin, G.L. Beets, J.W.A. Leijtens, A.K. Talsma, J.H.W. de Wilt, P.J. Tanis, M. Kusters, R. Hompes, J.B. Tuynman, Arend G.J. Aalbers, Susanna M. van Aalten, Femke J. Amelung, Marjolein Ankersmit, Imo
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Zhihong Li, Yiliyaer Aihemaiti, Qianqian Yang, Yiliminuer Ahemai, Zimei Li, Qianqian Du, Yan Wang, Hanxiang Zhang, Yingbin Cai
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O. A. Mainovskaya
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Lucille Quénéhervé, Mathieu Pioche, Jérémie Jacques
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Cecilia Binda, Matteo Secco, Luigi Tuccillo, Chiara Coluccio, Elisa Liverani, Carlo Felix Maria Jung, Carlo Fabbri, Giulia Gibiino
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Inflammatory bowel diseases

Risk of surgery in patients with stricturing type of Crohn’s disease at the initial diagnosis: a single center experience: Yuji Maehata, Yutaka Nagata, Tomohiko Moriyama, Yuichi Matsuno, Atsushi Hirano, Junji Umeno, Takehiro Torisu, Tatsuya Manabe, Takanari Kitazono, Motohiro Esaki; Intest Res 2019;17(3):357-364. Published online February 21, 2019; DOI: https://doi.org/10.5217/ir.2018.00107

Abstract PDF PubReader ePub

Background/Aims
It remains uncertain which patients with stricturing-type Crohn’s disease (CD) require early small bowel surgery after the initial diagnosis. We aimed to clarify clinical characteristics associated with the intervention in such condition of CD.
Methods
We retrospectively evaluated the clinical course of 53 patients with CD and small bowel strictures who were initially treated with medications after the initial diagnosis. We investigated possible associations between small bowel surgery and the following: clinical factors and radiologic findings at initial diagnosis and the types of medications administered during follow-up.
Results
Twenty-eight patients (53%) required small bowel resection during a median follow-up period of 5.0 years (range, 0.5–14.3 years). The cumulative incidence rates of small bowel surgery at 2, 5, and 10 years were 26.4%, 41.0%, and 63.2%, respectively. Univariate analysis indicated that obstructive symptoms (P=0.036), long-segment stricture (P<0.0001), and prestenotic dilation (P<0.0001) on radiography were associated with small bowel surgery, and immunomodulatory (P=0.037) and biological therapy (P=0.008) were significant factors during follow-up. Multivariate analysis revealed that long-segment stricture (hazard ratio [HR], 4.25; 95% confidence interval [CI], 1.78–10.53; P=0.001) and prestenotic dilation (HR, 3.41; 95% CI, 1.24–9.62; P=0.018) on radiography showed a positive correlation with small bowel surgery, and biological therapy (HR, 0.40; 95% CI, 0.15–0.99; P=0.048) showed a negative correlation.
Conclusions
CD patients with long-segment stricture and prestenotic dilation on radiography seem to be at a higher risk of needing small bowel surgery. For such patients, early surgical intervention might be appropriate, even at initial diagnosis.

Citations

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Colonic strictures in Crohn’s disease: a non-surgical survival
Sarra Laabidi, Hamed Aboubecrine, Salma Souissi, Donia Gouiaa, Asma Labidi, Nadia Ben Mustapha, Anis Haddad, Amine Sebai, Meriem Serghini, Monia Fekih, Hanene Jaziri, Jalel Boubaker
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Alexander T. Elford, Zaid Ardalan, Paul Simkin, Britt Christensen
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Dominik Bettenworth, Mark E. Baker, Joel G. Fletcher, Vipul Jairath, Cathy Lu, Willem Bemelman, Geert d’Haens, Andre d’Hoore, Axel Dignass, Iris Dotan, Roger Feakins, Phillip Fleshner, Christina Ha, Gaylyn Henderson, Ruishen Lyu, Julian Panes, Gerhard Rog
Nature Reviews Gastroenterology & Hepatology.2024; 21(8): 572. CrossRef
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Florian Rieder, Mark E. Baker, David H. Bruining, Jeff L. Fidler, Eric C. Ehman, Shannon P. Sheedy, Jay P. Heiken, Justin M. Ream, David R. Holmes, Akitoshi Inoue, Payam Mohammadinejad, Yong S. Lee, Stuart A. Taylor, Jaap Stoker, Guangyong Zou, Zhongya Wa
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Reliability of CT Enterography for Describing Fibrostenosing Crohn Disease
Florian Rieder, Christopher Ma, Jurij Hanzel, Joel G. Fletcher, Mark E. Baker, Zhongya Wang, Leonardo Guizzetti, Lisa M. Shackelton, Julie Rémillard, Mihir Patel, Jiafei Niu, Ronald Ottichilo, Cynthia S. Santillan, Nunzia Capozzi, Stuart A. Taylor, David
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Kush Fansiwala, Neha D. Shah, Kelly A. McNulty, Mary R. Kwaan, Berkeley N. Limketkai
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Sarcopenia hinders the decline in disease activity after surgery for people with Crohn's disease: Preliminary results
Asuka Yasueda, Yuki Sekido, Takashi Takeda, Takayuki Ogino, Norikatsu Miyoshi, Hidekazu Takahashi, Mamoru Uemura, Yuichiro Doki, Hidetoshi Eguchi, Tsunekazu Mizushima
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Julien D Schulberg, Emily K Wright, Bronte A Holt, Helen E Wilding, Amy L Hamilton, Alyson L Ross, Michael A Kamm
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Comparison of Long-term Outcomes of Infliximab versus Adalimumab in 1,488 Biologic-Naive Korean Patients with Crohn’s Disease
Yoon Suk Jung, Minkyung Han, Sohee Park, Jae Hee Cheon
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Molecular targets and the use of biologics in the management of small bowel fibrosis in inflammatory bowel disease
Muaad Abdulla, Thean Soon Chew
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Real world analysis on the efficacy and safety of anti-tumor necrosis factor therapy in patients with stricturing Crohn’s disease
Sudheer K. Vuyyuru, Bhaskar Kante, Peeyush Kumar, Pabitra Sahu, Saurabh Kedia, Mukesh Kumar Ranjan, Raju Sharma, Rajesh Panwar, Govind Makharia, Vineet Ahuja
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Manreet Kaur, Robin L. Dalal, Seth Shaffer, David A. Schwartz, David T. Rubin
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Surgical treatment of intestinal stricture in inflammatory bowel disease
Helen M. Mohan, John C. Coffey
Journal of Digestive Diseases.2020; 21(6): 355. CrossRef

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IBD

Efficacy of restarting anti-tumor necrosis factor α agents after surgery in patients with Crohn's disease: Sakiko Hiraoka, Shiho Takashima, Yoshitaka Kondo, Toshihiro Inokuchi, Yuusaku Sugihara, Masahiro Takahara, Seiji Kawano, Keita Harada, Jun Kato, Hiroyuki Okada; Intest Res 2018;16(1):75-82. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.75

Abstract PDF PubReader ePub

Background/Aims

The efficacy of anti-tumor necrosis factor α (anti-TNFα) antibodies for postoperative Crohn's disease (CD) in patients who were treated with these agents prior to surgery is largely unknown.

Methods

CD patients who underwent intestinal resection and received anti-TNFα agents after surgery were divided into 2 groups according to the presence or absence of preoperative anti-TNFα treatment: anti-TNFα restart group or anti-TNFα naïve group. Endoscopic recurrence after surgery was examined according to the preoperative conditions, including administration of anti-TNFα agents before surgery.

Results

Thirty-six patients received anti-TNFα antibody after surgery: 22 in the anti-TNFα restart group and 14 in the anti-TNFα naïve group. Endoscopic recurrence after surgery was more frequently observed in the anti-TNFα restart group than in the anti-TNFα naïve group (68% vs. 14%, P<0.001). Multivariate analysis revealed the following significant risk factors of endoscopic recurrence after surgery: anti-TNF restart group (odds ratio [OR], 28.10; 95% CI, 3.08–722.00), age at diagnosis <23 years (OR, 24.30; 95% CI, 1.67–1,312.00), serum albumin concentration at surgery <3.3 g/dL (OR, 34.10; 95% CI, 1.72–2,804.00), and presence of inflammation outside of the surgical site (OR, 21.40; 95% CI, 1.02–2,150.00). Treatment intensification for patients with endoscopic recurrence in the anti-TNFα restart group showed limited responses, with only 1 of 12 patients achieving endoscopic remission.

Conclusions

The efficacy of restarting anti-TNFα antibody treatment after surgery was limited, and treatment intensification or a change to different classes of biologics should be considered for those patients.

Citations

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Influence of preoperative anti TNF alpha antibody therapy on postoperative recurrence of Crohn’s disease
Yuki Sekido, Takayuki Ogino, Takashi Takeda, Mitsunobu Takeda, Tsuyoshi Hata, Atsushi Hamabe, Hidekazu Takahashi, Norikatsu Miyoshi, Mamoru Uemura, Yuichiro Doki, Hidetoshi Eguchi, Tsunekazu Mizushima
Scientific Reports.2025;[Epub] CrossRef
Efficacy of Consistency Versus Switching of Biologics for Prevention of Postoperative Recurrence in Crohn’s Disease: A Multicenter Real-World Retrospective Study
Chunjie Zhang, Juan Wu, Zhaoxiu Liu, Leilei Luo, Wen Tang, Jing Sun, Fenfen Wang, Yan Chen, Yanjun Chen, Wei Han, Meijiao Lu, Zhaolian Bian, Cuihua Lu, Naizhong Hu, Lanxiang Zhu, Xiujun Liao, Yi Li
Inflammatory Bowel Diseases.2025;[Epub] CrossRef
Common Mistakes in Managing Patients with Inflammatory Bowel Disease
Javier P. Gisbert, María Chaparro
Journal of Clinical Medicine.2024; 13(16): 4795. CrossRef
Anti-TNF Agents and New Biological Agents (Vedolizumab and Ustekinumab) in the Prevention and Treatment of Postoperative Recurrence After Surgery in Crohn’s Disease
Javier P. Gisbert, María Chaparro
Drugs.2023; 83(13): 1179. CrossRef
Nutrition, Nutritional Status, Micronutrients Deficiency, and Disease Course of Inflammatory Bowel Disease
Marco Valvano, Annalisa Capannolo, Nicola Cesaro, Gianpiero Stefanelli, Stefano Fabiani, Sara Frassino, Sabrina Monaco, Marco Magistroni, Angelo Viscido, Giovanni Latella
Nutrients.2023; 15(17): 3824. CrossRef
Patient sex does not affect endoscopic outcomes of biologicals in inflammatory bowel disease but is associated with adverse events
Mitchell R. K. L. Lie, Emma Paulides, C. Janneke van der Woude
International Journal of Colorectal Disease.2020; 35(8): 1489. CrossRef
Adalimumab or Infliximab for the Prevention of Early Postoperative Recurrence of Crohn Disease: Results From the ENEIDA Registry
Fiorella Cañete, Míriam Mañosa, María José Casanova, Ramiro C González-Sueyro, Jesús Barrio, Fernando Bermejo, Pilar Nos, Eva Iglesias-Flores, Esther García-Planella, José Lázaro Pérez-Calle, Raquel Vicente, Maribel Vera, Laura Ramos, Montserrat Rivero, R
Inflammatory Bowel Diseases.2019; 25(11): 1862. CrossRef
Maneuvering Clinical Pathways for Crohn’s Disease
Thomas X. Lu, Russell D. Cohen
Current Gastroenterology Reports.2019;[Epub] CrossRef
Author's Reply
Sakiko Hiraoka, Jun Kato, Hiroyuki Okada
Intestinal Research.2018; 16(2): 321. CrossRef
The old versus the new: which do you keep in postoperative Crohn's disease?
Paulo Gustavo Kotze, Christopher Ma, Miguel Regueiro, Remo Panaccione
Intestinal Research.2018; 16(2): 319. CrossRef

6,985 View
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Surgical management of inflammatory bowel disease in China: a systematic review of two decades: Qiao Yu, Ren Mao, Lei Lian, Siew chien Ng, Shenghong Zhang, Zhihui Chen, Yanyan Zhang, Yun Qiu, Baili Chen, Yao He, Zhirong Zeng, Shomron Ben-Horin, Xinming Song, Minhu Chen; Intest Res 2016;14(4):322-332. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.322

Abstract PDF Supplementary Material PubReader

Background/Aims

The past decades have seen increasing incidence and prevalence of inflammatory bowel disease (IBD) in China. This article aimed to summarize the current status and characteristics of surgical management for IBD in China.

Methods

We searched PubMed, Embase, and Chinese databases from January 1, 1990 to July 1, 2014 for all relevant studies on the surgical treatment IBD in China. Eligible studies with sufficient defined variables were further reviewed for primary and secondary outcome measures.

Results

A total of 74 studies comprising 2,007 subjects with Crohn's disease (CD) and 1,085 subjects with ulcerative colitis (UC) were included. The percentage of CD patients misdiagnosed before surgery, including misdiagnosis as appendicitis or UC, was 50.8%±30.9% (578/1,268). The overall postoperative complication rate was 22.3%±13.0% (267/1,501). For studies of UC, the overall postoperative complication rate was 22.2%±27.9% (176/725). In large research centers (n>50 surgical cases), the rates of emergency operations for CD (P=0.032) and in-hospital mortalities resulting from both CD and UC were much lower than those in smaller research centers (n≤50 surgical cases) (P=0.026 and P <0.001, respectively). Regarding the changes in CD and UC surgery over time, postoperative complications (P=0.045 for CD; P=0.020 for UC) and postoperative in-hospital mortality (P=0.0002 for CD; P=0.0160 for UC) both significantly improved after the year 2010.

Conclusions

The surgical management of IBD in China has improved over time. However, the rates of misdiagnosis and postoperative complications over the past two decades have remained high. Large research centers were found to have relatively better capacity for surgical management than the smaller ones. Higher quality prospective studies are needed in China.

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Remdesivir alleviates inflammation and tissue damage in experimental colitis via AnxA5 Signaling
Hailong Li, Ying Yang, Jinhe Li, Yayue Hu, Ruiqi Mao, Xiaoman Ye, Xi Wu, Zherui Li, Liqing Han, Xiaoting Gu, Hailong Cao, Honggang Zhou, Cheng Yang
International Immunopharmacology.2026; 169: 116029. CrossRef
Carbon monoxide produced by HO-1 upregulation is the main factor behind the abnormal motility seen in experimental ulcerative colitis in mice
Mengchao Zhao, Yaru Lei, Mengyuan Wang, Yixin Chen, Shaozhang Hou, Xinyuan Dai, Di Gao, Yudan Liu, Bruno Mazet, Lei Sha
American Journal of Physiology-Gastrointestinal and Liver Physiology.2025; 328(3): G311. CrossRef
Epidemiological research, burden, and clinical advances of inflammatory bowel disease in China
Hong Yang, Jiaming Qian
Chinese Medical Journal.2024; 137(9): 1009. CrossRef
Laparoscopic surgery contributes to a decrease in short-term complications in surgical ulcerative colitis patients during 2008–2017: a multicenter retrospective study in China
Zerong Cai, Xiaosheng He, Jianfeng Gong, Peng Du, Wenjian Meng, Wei Zhou, Jinbo Jiang, Bin Wu, Weitang Yuan, Qi Xue, Lianwen Yuan, Jinhai Wang, Jiandong Tai, Jie Liang, Weiming Zhu, Ping Lan, Xiaojian Wu
Intestinal Research.2023; 21(2): 235. CrossRef
Differences in inflammatory bowel diseases between East and West: a Chinese perspective
Guanglin Cui, Junling Li, Hanzhe Liu, Jann-Birger Laugsand, Zhanju Liu
Journal of Public Health.2021; 29(1): 19. CrossRef
Diagnostic and Predictive Value of Immune-Related Genes in Crohn’s Disease
Bing Yu, Yi-xin Yin, Yan-ping Tang, Kang-lai Wei, Zhi-gang Pan, Ke-Zhi Li, Xian-wen Guo, Bang-li Hu
Frontiers in Immunology.2021;[Epub] CrossRef
Role of a multidisciplinary team (MDT) in the diagnosis, treatment, and outcomes of inflammatory bowel disease: a single Chinese center's experience
Qiang Wu, Xuehong Wang, Feng Wu, Dehong Peng, Guotao Wu, Lichao Yang, Lianwen Yuan
BioScience Trends.2021; 15(3): 171. CrossRef
MANAGEMENT OF ILEOCECAL CROHN’S DISEASE DURING SURGICAL TREATMENT FOR ACUTE APPENDICITIS: A SYSTEMATIC REVIEW
Abel Botelho QUARESMA, Eron Fabio MIRANDA, Paulo Gustavo KOTZE
Arquivos de Gastroenterologia.2021; 58(4): 560. CrossRef
Risk factors and long-term outcome of disease extent progression in Asian patients with ulcerative colitis: a retrospective cohort study
Yun Qiu, Baili Chen, Yufei Li, Shanshan Xiong, Shenghong Zhang, Yao He, Zhirong Zeng, Shomron Ben-Horin, Minhu Chen, Ren Mao
BMC Gastroenterology.2019;[Epub] CrossRef
Initial medical and surgical management of inflammatory bowel disease in the biologic era: A comparison between the United States and China
Sanskriti Varma, Jun Hu, Ambar Mehta, Yiran Song, Angela Park, Min Zhi, Susan Hutfless
JGH Open.2019; 3(3): 234. CrossRef
Can molecular stratification improve the treatment of inflammatory bowel disease?
Claire Wang, Hannah M. Baer, Daniel R. Gaya, Robert J.B. Nibbs, Simon Milling
Pharmacological Research.2019; 148: 104442. CrossRef
Intrarectally administered polaprezinc attenuates the development of dextran sodium sulfate‑induced ulcerative colitis in mice
Zhaoyang Liu, Wenbo Xie, Mingru Li, Jing Liu, Xiao Liang, Tao Li
Experimental and Therapeutic Medicine.2019;[Epub] CrossRef
Changing treatment paradigms for the management of inflammatory bowel disease
Jong Pil Im, Byong Duk Ye, You Sun Kim, Joo Sung Kim
The Korean Journal of Internal Medicine.2018; 33(1): 28. CrossRef
Is Adsorptive Granulocyte and Monocyte Apheresis Effective as an Alternative Treatment Option in Patients with Ulcerative Colitis?
Seong Ran Jeon
Gut and Liver.2017; 11(2): 171. CrossRef

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A retrospective analysis of 20-year data of the surgical management of ulcerative colitis patients in Taiwan: a study of Taiwan Society of Inflammatory Bowel Disease: Chun-Chi Lin, Shu-Chen Wei, Been-Ren Lin, Wen-Sy Tsai, Jinn-Shiun Chen, Tzu-Chi Hsu, Wei-Chen Lin, Tien-Yu Huang, Te-Hsin Chao, Hung-Hsin Lin, Jau-Min Wong, Jen-Kou Lin; Intest Res 2016;14(3):248-257. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.248

Abstract PDF PubReader ePub

Background/Aims

With the recent progress in medical treatment, surgery still plays a necessary and important role in treating ulcerative colitis (UC) patients. In this study, we analyzed the surgical results and outcomes of UC in Taiwan in the recent 20 years, via a multi-center study through the collaboration of Taiwan Society of IBD.

Methods

A retrospective analysis of surgery data of UC patients from January 1, 1995, through December 31, 2014, in 6 Taiwan major medical centers was conducted. The patients' demographic data, indications for surgery, and outcome details were recorded and analyzed.

Results

The data of 87 UC patients who received surgical treatment were recorded. The median post-operative follow-up duration was 51.1 months and ranged from 0.4 to 300 months. The mean age at UC diagnosis was 45.3±16.0 years and that at operation was 48.5±15.2 years. The 3 leading indications for surgical intervention were uncontrolled bleeding (16.1%), perforation (13.8%), and intractability (12.6%). In total, 27.6% of surgeries were performed in an emergency setting. Total or subtotal colectomy with rectal preservation (41.4%) was the most common operation. There were 6 mortalities, all due to sepsis. Emergency operation and low pre-operative albumin level were significantly associated with poor survival (P=0.013 and 0.034, respectively).

Conclusions

In the past 20 years, there was no significant change in the indications for surgery in UC patients. Emergency surgeries and low pre-operative albumin level were associated with poor survival. Therefore, an optimal timing of elective surgery for people with poorly controlled UC is paramount.

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Hsu-Heng Yen, Jia-Feng Wu, Horng-Yuan Wang, Ting-An Chang, Chung-Hsin Chang, Chen-Wang Chang, Te-Hsin Chao, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tzu-Chi Hsu, Tien-Yu Huang, Tsung-I Hung, Puo-Hsien Le, Chun-Che Lin, Chun-Chi Lin
Intestinal Research.2024; 22(3): 213. CrossRef
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Zhobin Moghadamyeghaneh, Murwarid Rahimi, Katherine Kopatsis, Anthony Paul Kopatsis, Anthony Kopatsis
The American Surgeon.2022; 88(7): 1411. CrossRef
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Yuan-Fang Zhou, Ning Sun, Shi-Rui Cheng, Xiao-Dong Deng, Xiang-Yin Ye, Zheng-Jie Li, Jun Zhou, Gui-Xing Xu, Yu-Zhu Qu, Liu-Yang Huang, Rui-Rui Sun, Fan-Rong Liang
BMJ Open.2021; 11(8): e045090. CrossRef
Recent Advance in the Management of Dysplasia in the Ulcerative Colitis
Dong-Hoon Yang
Journal of Digestive Cancer Reports.2021; 9(2): 50. CrossRef
Trends and risk factors of mortality analysis in patients with inflammatory bowel disease: a Taiwanese nationwide population-based study
Wei-Chen Lin, Meng-Tzu Weng, Chien-Chih Tung, Yuan-Ting Chang, Yew-Loong Leong, Yu-Ting Wang, Horng-Yuan Wang, Jau-Min Wong, Shu-Chen Wei
Journal of Translational Medicine.2019;[Epub] CrossRef
Variant Two-Stage Ileal Pouch-Anal Anastomosis: An Innovative and Effective Alternative to Standard Resection in Ulcerative Colitis
Jennifer Samples, Krista Evans, Nicole Chaumont, Paula Strassle, Timothy Sadiq, Mark Koruda
Journal of the American College of Surgeons.2017; 224(4): 557. CrossRef

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Clinical Features and Prognosis of Resectable Primary Colorectal Signet-Ring Cell Carcinoma: Ho-Su Lee, Jae Seung Soh, Seohyun Lee, Jung Ho Bae, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sun A Kim, Young Soo Park, Seok-Byung Lim, Jin Cheon Kim, Chang Sik Yu, Dong-Hoon Yang; Intest Res 2015;13(4):332-338. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.332

Abstract PDF PubReader ePub

Background/Aims

We attempted to investigate the prognosis of signet-ring cell carcinoma (SRC) patients who underwent curative surgery by comparing them with age-, sex-, and stage-matched non-mucinous adenocarcinoma (NMAC) patients.

Methods

Between January 2003 and December 2011, 19 patients with primary SRC of the colorectum underwent curative surgery. Four SRC patients under the age of 40 were excluded, and the clinicopathological data of 15 patients (7 men; median age, 56 years) were reviewed and compared with the data of 75 NMAC patients matched by age, sex, and pathologic stage.

Results

The median follow-up duration was 30.1 months for the SRC group and 43.7 months for the NMAC group (P=0.141). Involvement of the left side of the colon (73.3% vs. 26.7%, P=0.003) and infiltrative lesions such as Borrmann types 3 and 4 (85.7% vs. 24.0%, P=0.001) were more common in the SRC group than in the NMAC group. The five-year overall survival rate was significantly lower for patients with SRC than for those with NMAC (46.0% vs. 88.7%, hazard ratio, 6.99; 95% confidence interval, 2.33-20.95, P=0.001).

Conclusions

Patients with even resectable primary colorectal SRC had a poorer prognosis than age-, sex-, and stage-matched colorectal NMAC patients.

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Computerized Medical Imaging and Graphics.2023; 107: 102242. CrossRef
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Jie Mao, Peng Du, Han-teng Yang, Huan Hu, Shi-Yao Wang, Xia Wu, Zhi-Bin Cheng
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Yong-Ping Yang, Ling-Yun Yu, Jian Shi, Jian-Nan Li, Xin-Yu Wang, Tong-Jun Liu
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Luis I. Pozos-Ochoa, Leonardo S. Lino-Silva, Alberto M. León-Takahashi, Rosa A. Salcedo-Hernández
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Case Report

Coexistence of Solitary Rectal Ulcer Syndrome and Ulcerative Colitis: A Case Report and Literature Review: Hyun Bum Park, Hyung Chul Park, Cho Yun Chung, Jong Sun Kim, Dae Sung Myung, Sung Bum Cho, Wan Sik Lee, Young Eun Joo; Intest Res 2014;12(1):70-73. Published online January 28, 2014; DOI: https://doi.org/10.5217/ir.2014.12.1.70

Abstract PDF PubReader

Solitary rectal ulcer syndrome (SRUS) is an uncommon benign disease that is misdiagnosed as malignancy or inflammatory bowel disease because of similarities in clinical and endoscopic manifestations. Furthermore, SRUS with ulcerative colitis (UC) is extremely rare. To date, two cases have been reported in the medical literature. We report an additional case of SRUS with UC that was misdiagnosed as rectal cancer. A 61-year-old man was admitted to our hospital with rectal bleeding. Colonoscopy showed a well-demarcated, shallow, ulcerative lesion with polypoidal growth involving the entire circumference of the rectal lumen. Findings from imaging studies, including abdominal computed tomography (CT) and positron emission tomography (PET)/CT resembled those of rectal cancer. Surgical resection was performed because clinical symptoms persisted despite medical treatment and because occult rectal cancer could not be ruled out. Histopathological examination of the resected specimen revealed fibromuscular obliteration of the lamina propria and crypt abscesses, characteristics compatible with SRUS and UC.

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