Positive Resection Margins in Crohn's Disease Significantly Increase the Likelihood of Disease Recurring After Surgery.

Disease recurrence postoperatively in Crohn's disease remains a signicant concern despite rapid progress in surgical and medical treatments. To better identify at-risk patients and develop targeted therapeutic approaches, more criteria are required. The inuence of resection margins on disease recurrence is still uncertain, and general guidelines are lacking. A single-center retrospective study was conducted, including all patients who underwent ileocecal resection due to Crohn's disease. The resection margins were evaluated by two independent pathologists using histopathological criteria from previous consensus reports.The study included 114 patients, with a median follow-up of 35 months. The analysis revealed that while postoperative morbidity was unaffected, positive resection margins are signicantly increased the rates of severe endoscopic recurrence at 6 months (15.6% vs. 2.0%, p = 0.02) and overall (19.6% vs. 4.2%, p = 0.001), leading to a higher rate of surgical recurrence (4.5% vs. 0%, p = 0.04). The presence of positive margins was identied as an independent risk factor for severe recurrence of endoscopic disease in a multivariate analysis. Therefore, positive margins are an independent risk factor for both postoperative endoscopic and surgical disease recurrence. Prospective studies are required to determine whether patients with positive resection margins would benet from extended resection or postoperative medical prophylaxis.