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Publications

Journal Article Ahead of print

PubMed: 42456915 DOI: 10.1016/j.cgh.2026.06.034

Time trends in strategies for postoperative Crohn's disease management and long-term surgical recurrence: ENEIDA registry data.

Clin Gastroenterol Hepatol

Authors: Gisela Piñero, Míriam Mañosa, Guillermo Bastida, Elena Ricart, Margalida Calafat, Ruth De Francisco, Francisco Mesonero, Eva Iglesias-Flores, Marta Maia Bosca-Watts, Isabel Vera, Luisa de Castro, María Dolores Martín-Arranz, Cristina Alba, Montserrat Rivero, Jordi Guardiola, Laura Arranz-Hernández, Lara Arias-García, Pilar Varela, Antonio Giordano, Javier P Gisbert, Jesús Barrio, Eduard Brunet-Mas, Olivia Belén-Galipienso, Santiago García-López, Eugeni Domènech

Affiliations

  • Hospital Universitari Germans Trias i Pujol (Badalona).
  • Hospital Universitari Germans Trias i Pujol (Badalona); Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).
  • Hospital Universitari i Politècnic La Fe, València.
  • Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD); Hospital Clínic de Barcelona, IDIBAPS.
  • Hospital Universitari Germans Trias i Pujol (Badalona); Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).
  • Hospital Universitario Central de Asturias and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo.
  • Hospital Universitario Ramón y Cajal, Madrid.
  • Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD); Hospital Universitario Reina Sofía Córdoba, IMIBI, UCO.
  • Hospital Clínico Universitario, València.
  • Hospital Universitario Puerta de Hierro, Majadahonda.
  • Hospital Álvaro Cunqueiro, Vigo and Instituto de Investigación Sanitaria Galicia Sur.
  • Hospital Universitario La Paz, Universidad Autónoma de Madrid and La Paz Institute for Health Research, Madrid.
  • Hospital Clínico San Carlos, Madrid.
  • Hospital Universitario Marqués de Valdecilla e Instituto de Investigación IDIVAL.
  • Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat.
  • Hospital Nuestra Señora de la Candelaria, Tenerife.
  • Hospital Universitario de Burgos.
  • Hospital Universitario de Cabueñes, Gijón.
  • Hospital Universitari de la Santa Creu i Sant Pau, Institut de Recerca Sant Pau, Barcelona.
  • Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD); Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid and Universidad Autónoma de Madrid.
  • Hospital Universitario Río Hortega, Valladolid.
  • Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD); Hospital Universitari Parc Taulí and Institut d'Investigació i Innovació ParcTaulí (I3PT-CERCA), Sabadell.
  • Hospital General Dr Balmis and ISABIAL, Alicante.
  • Hospital Universitario Miguel Servet, Zaragoza.
  • Hospital Universitari Germans Trias i Pujol (Badalona); Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD); Universitat Autònoma de Barcelona.

Abstract

BACKGROUND

The availability of biologicals has been associated with a decreased rate of first intestinal resection in patients with Crohn's disease (CD). However, its impact on postoperative recurrence (POR) has received little attention. We aimed to assess time trends in the strategies for the management of postoperative CD and the rate of second surgeries over the last three decades.

METHODS

Adult patients with CD who had undergone a first ileocolic resection between 1990 and 2020 were identified from the Spanish ENEIDA registry. Patients were grouped by date of surgery as follows: before the biological era ([BB] 1990-2000), in the early biological era ([EB] 2000-2010), and in the widespread biological era ([WB] 2011-2020).

RESULTS

A total of 4,890 patients were included (23% BB, 38% EB, 39% WB). A significant increase in medical prevention of POR with both thiopurines (BB 12%, EB 47%, WB 37%; P<0.001) and biological agents (BB 0%, EB 9%, WB 37%; P<0.001) was observed. Medical treatment with biologicals for POR also increased (BB 35%, EB 48%, WB 43%; P<0.001). The cumulative surgical POR-free survival rate at five and ten years was significantly higher in both EB and WB cohorts as compared to BB (BB 92%, 83%; EB 96%, 90%; WB 97%and 91%, respectively; P<0.001).

CONCLUSIONS

Medical prevention for POR after the first intestinal resection for CD increased significantly in the last two decades, alongside the use of biologicals to treat POR. These changes were associated with a significant decrease in the cumulative probability of surgical POR.

MeSH

Registries, Disease Management, Crohn Disease, Digestive System Diseases