Extended mesenteric resection in surgical management of Crohn’s disease: short- and long-term outcomes

The OBJECTIVE was to conduct a comparative analysis of short- and long-term outcomes following extended versus standard mesenteric resection in patients with stricturing Crohn’s disease.

METHODS AND MATERIALS. This study was conducted at the Department of Coloproctology of the Loginov Moscow Clinical Scientific Center (2015–2023). The study included 120 patients with confirmed diagnosis “Crohn’s disease” (stricturing phenotype). The main group included 60 patients (prospective group) who underwent extended mesenteric resection. The comparison group included 60 patients (retrospective group) who underwent standard mesenteric resection.

RESULTS. Multivariate regression analysis incorporating gender, age at diagnosis, surgical history, postoperative medical prophylaxis, smoking status, extent of mesenteric resection (standard vs extended), intestinal continuity restoration method (primary anastomosis vs stoma formation), disease phenotype, and perianal manifestations revealed that standard mesenteric resection was the only independent risk factor for postoperative Crohn’s disease recurrence (HR 2.83; 95 % CI 1.01–7.96; p=0.048).

CONCLUSION. Extended mesenteric resection represents a promising surgical approach for Crohn’s disease that may reduce postoperative recurrence rates through complete removal of inflammation-sustaining mesenteric tissues.

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