Extended mesenteric resection in Crohn's disease: EXCEED Study Protocol-a blinded multicenter randomized controlled...

Area of Science:

• Gastroenterology and Hepatology
• Surgical Oncology
• Inflammatory Bowel Disease Research

Background:

• Crohn's disease recurrence post-intestinal resection poses significant patient and healthcare challenges.
• Emerging evidence suggests extended mesenteric excision may be a strategy to mitigate recurrence.
• The EXCEED study investigates the role of the mesentery in Crohn's disease recurrence.

Purpose of the Study:

• To evaluate the efficacy of extended mesenteric resection in preventing Crohn's disease recurrence.
• To compare outcomes between extended mesenteric resection and standard resection techniques.
• To provide evidence-based insights into surgical management of Crohn's disease.

Main Methods:

• Blinded, multicenter randomized controlled trial (RCT) involving 208 patients.
• Patients randomized to extended mesenteric resection (Group A) or standard resection (Group B).
• Primary endpoint: endoscopic recurrence (Rutgeerts score > i2a) at 12 months; secondary endpoints include clinical recurrence and long-term outcomes.

Main Results:

• Study is currently enrolling patients and has not yet produced results.
• Data collection for primary and secondary endpoints is ongoing.
• Tertiary endpoints include impact of disease severity, biological treatment, complications, patient-reported outcomes, and cost-effectiveness.

Conclusions:

• This study addresses a critical gap in understanding Crohn's disease recurrence post-surgery.
• Findings are expected to inform surgical best practices for Crohn's disease management.
• The research aims to enhance patient outcomes by potentially reducing disease recurrence.