Clinical outcomes of conventional versus extended mesenteric resection in limited ileo-colonic Crohn’s disease: a systematic review and meta-analysis

PMCID: PMC12174243

PMID: 40528089

DOI: 10.1007/s00384-025-04937-3

Journal: International journal of colorectal disease

Publication Date: 2025-6-18

Authors: Mostafa OE, Zaman S, Malik M, Kumar P, Kumar L, et al.

Key Points

• No significant clinical advantage was observed with extended mesenteric resection compared to conventional resection in Crohn's disease
• Comprehensive meta-analysis of 4,358 patients showed comparable outcomes across multiple surgical metrics
• Surgeons should consider traditional limited resection techniques as equally effective for ileo-colonic Crohn's disease management

Summary

This comprehensive meta-analysis investigated the clinical outcomes of extended mesenteric resection (EMR) versus conventional mesenteric resection (CMR) in patients with limited ileo-colonic Crohn's disease (CD). Analyzing five studies encompassing 4,358 patients (993 EMR, 3,365 CMR), the research aimed to determine whether an extended surgical approach provides meaningful clinical advantages.

Contrary to potential hypotheses, the meta-analysis revealed no statistically significant differences across multiple critical outcomes, including disease recurrence (OR: 0.49, CI 0.21-1.16, P=0.10), re-operation rates (OR: 0.33, CI 0.06-1.65, P=0.17), and post-operative complications. These findings suggest that the more extensive surgical technique does not confer additional clinical benefits for patients with limited ileo-colonic CD, challenging existing surgical paradigms and highlighting the need for larger, more definitive randomized controlled trials.