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Statement

IBD

Proposal of novel staging system CNM (Crohn’s primary site, nodes, mesentery) to predict postoperative recurrence of Crohn’s disease: Guduru Venkat Rao, Partha Pal, Anuradha Sekaran, Pradeep Rebala, Manu Tandan, D. Nageshwar Reddy; Intest Res 2023;21(2):196-204. Published online August 8, 2022; DOI: https://doi.org/10.5217/ir.2022.00045

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After oncologic resection, histological grading and staging of the tumor give important prognostic information about the future risk of recurrence and hence influence the subsequent management plan. Several studies and their meta-analysis have shown that various histological features (e.g., microscopic positive resection margins, plexitis, granuloma, mesenteric inflammatory activity) can predict postoperative clinical/endoscopic/surgical recurrence after resection in Crohn’s disease (CD). Inclusion of mesentery in surgical resection specimens has been shown to reduce surgical recurrence after ileocolonic resection in CD. However, there is no uniform histopathological staging system for risk stratification in postoperative CD to systematically predict postoperative recurrence. This is because the prediction to date is based on clinical characteristics (smoking status, disease phenotype, surgical history). Histopathological predictors are still not adopted in routine clinical practice due to the lack of a uniform staging system, heterogeneity of published studies and lack of standardized definition of histological features. In this article, we attempted to incorporate all such histological features in a single histological staging system CNM (Crohn’s primary site [resection margin positivity, plexitis, granuloma, depth of infiltration], nodes [presence of granuloma], mesentery [involved or not]) in surgical resection specimen in CD. The proposed CNM classification would help to enable systematic reporting, design future clinical trials, stratify postoperative recurrence risk and choose appropriate postoperative prophylaxis.

Citations

Citations to this article as recorded by

Endoscopic Assessment of Postoperative Recurrence in Crohn's Disease
Partha Pal, D. Nageshwar Reddy, Guduru Venkat Rao
Gastrointestinal Endoscopy Clinics of North America.2025; 35(1): 121. CrossRef
Managing Crohn’s Disease Postoperative Recurrence Beyond Prophylaxis: A Comprehensive Review with Meta-Analysis
Andrei Ovidiu Olteanu, Artsiom Klimko, Eugen Nicolae Tieranu, Andreea Daniela Bota, Carmen Monica Preda, Ioana Tieranu, Christopher Pavel, Mihai Radu Pahomeanu, Cristian Valentin Toma, Adrian Saftoiu, Elena Mirela Ionescu, Cristian George Tieranu
Biomedicines.2024; 12(11): 2434. CrossRef

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Original Article

Inflammatory Bowel Diseases

Very early onset inflammatory bowel disease in a South Asian country where inflammatory bowel disease is emerging: a distinct clinical phenotype from later onset disease: Rupa Banerjee, Partha Pal, Zaheer Nabi, Upender Shava, Girish Ganesh, D. Nageshwar Reddy; Intest Res 2021;19(4):398-407. Published online November 20, 2020; DOI: https://doi.org/10.5217/ir.2020.00107

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Background/Aims
Information on pediatric inflammatory bowel disease (PIBD) and very early onset IBD (VEOIBD) are sparse in India, where IBD is emerging. We aimed to evaluate characteristics of VEOIBD and later onset PIBD (LO-PIBD) in India.
Methods
We performed retrospective analysis of a large, prospectively maintained IBD registry. PIBD was divided in to VEOIBD ( < 6 years) and LO-PIBD (6–17 years). Demographic data, disease characteristics and treatment were compared between the PIBD groups and with other Asian/Western studies as well as the adult patients of the registry.
Results
Of 3,752 IBD patients, 292 (7.8%) had PIBD (0–17 years) (175 Crohn’s disease [CD], 113 ulcerative colitis [UC], 4 IBD-undifferentiated; 22 VEOIBD [7.5%], and 270 LO-PIBD [92.5%]). VEOIBD patients had more severe disease compared to LO-PIBD in both UC (P= 0.003) and CD (P< 0.001). Familial IBD was more common in VEOIBD (13.6%) compared to LO-PIBD (9.2%). Ileal disease (L1) was an independent risk factor for diagnostic delay in pediatric CD. Diagnostic delay ( > 6 months) was significantly lower in VEOIBD (40.9%) than in LO-PIBD (78.8%) (P< 0.001). Compared to other Asian and Western studies, extensive UC (72.5%) and complicated CD (stricturing/penetrating: 42.7%) were relatively more common. Perianal CD was relatively less frequent (7.4%). PIBD had a significantly higher number of complicated and ileal CD and extensive UC comparison to adult cohort of the registry.
Conclusions
VEOIBD has more aggressive phenotype than LO-PIBD. Disease appears distinct from other Asian and Western studies and adult onset disease, with more complicated CD and extensive UC.

Citations

Citations to this article as recorded by

Delays in Diagnosing Pediatric Inflammatory Bowel Disease in Korea: Impact on Disease Severity and the Need for Early Recognition
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Journal of Korean Medical Science.2026;[Epub] CrossRef
Clinical characteristics and treatment patterns of older and younger patients with inflammatory bowel disease
Fatih Kivrakoglu, Vedat Kilic, Mustafa Ergin, Harun Kucuk, Cagdas Erdogan, Ilhami Yuksel
World Journal of Gastroenterology.2026;[Epub] CrossRef
Diagnostic interval of inflammatory bowel disease in Chinese children and its relationship with growth parameters: a retrospective study
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Frontiers in Pediatrics.2025;[Epub] CrossRef
Inflammatory bowel disease in south Asia: a scoping review
Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
The Lancet Gastroenterology & Hepatology.2025; 10(3): 259. CrossRef
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Way-Seah Lee, Kee-Seang Chew, James-Guoxian Huang, Pornthep Tanpowpong, Karen S. C. Mercado, Almida Reodica, Veena Logarajah, K. L. W. Hathagoda, Shaman Rajindrajith, Yoko Kin-Yoke Wong, Suporn Treepongkaruna, Marion Margaret Aw
Frontiers in Pediatrics.2025;[Epub] CrossRef
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Xiaolu Nie, Jing Li, Hui Xu, Fang Hu, Xiaolin Ye, Mengmeng Yu, Guoshuang Feng, Yueping Zeng, Xin Ni, Jie Wu, Xiaoxia Peng
Pediatric Investigation.2025; 9(3): 282. CrossRef
Management of pediatric inflammatory bowel diseases in limited‐resource settings: A position paper from the Paediatric IBD Porto Group of ESPGHAN
Almuthe Christine Hauer, Mutaz Sultan, Andy Darma, Eyad Altamimi, Daniela Elena Serban, Amit Assa, Claudia Patricia Sánchez Franco, Lissy de Ridder, David C. Wilson, Nadeem Ahmad Afzal, Jiri Bronsky, Miglena Georgieva, Marina Aloi, Vaidotas Urbonas, Vícto
Journal of Pediatric Gastroenterology and Nutrition.2025; 81(3): 866. CrossRef
Clinical features and outcomes of perianal disease in pediatric onset Crohn’s disease
Lin Wang, Yuhuan Wang, Ping Li, Shengnan Wang, Cuifang Zheng, Ying Huang
Digestive and Liver Disease.2025; 57(12): 2331. CrossRef
Advanced therapy is delayed in pediatric South Asian inflammatory bowel disease patients in the United States
Megha Tandon, Jennifer Bachand, Nurgul Yegembayeva, Lauren V. Collen, Sushrut Jangi
Journal of Pediatric Gastroenterology and Nutrition.2025; 81(6): 1469. CrossRef
Asian–Pacific perspectives on the management of very early-onset inflammatory bowel disease
Ichiro Takeuchi, Katsuhiro Arai, Pornthep Tanpowpong, Ming-Wei Lai, Andrew S Day, Way Seah Lee, James Guoxian Huang, Karen Sophia Calixto-Mercado, Rosanna Ming Sum Wong, Muhammad Arshad Alvi, Zubin Grover, Jung Ok Shim, Ujjal Poddar
Intestinal Research.2025; 23(4): 405. CrossRef
Spectrum and trend of pediatric inflammatory bowel disease: A two-decade experience from northern India
Neelam Mohan, Shivani Deswal, Anubhuti Bhardwaj
Indian Journal of Gastroenterology.2024; 43(1): 208. CrossRef
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Sahana Shankar, Snehali Majumder, Suparna Mukherjee, Anirban Bhaduri, Rangarajan Kasturi, Subrata Ghosh, Marietta Iacucci, Uday N. Shivaji
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef
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Way Seah Lee, Katsuhiro Arai, George Alex, Suporn Treepongkaruna, Kyung Mo Kim, Chee Liang Choong, Karen S. C. Mercado, Andy Darma, Anshu Srivastava, Marion M. Aw
Journal of Gastroenterology and Hepatology.2023; 38(4): 523. CrossRef
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Hala H. Mansour, Saeed S. Seddek, Manal E. Abd E. L. Meguid, Ayman E. Eskander, Sara T. Galal
Indian Journal of Gastroenterology.2023; 42(2): 185. CrossRef
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Gastroenterology.2022; 162(4): 1147. CrossRef
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James Guoxian Huang, Yoko Kin Yoke Wong, Kee Seang Chew, Pornthep Tanpowpong, Karen Sophia Calixto Mercado, Almida Reodica, Shaman Rajindrajith, Kai-Chi Chang, Yen-Hsuan Ni, Suporn Treepongkaruna, Way-Seah Lee, Marion Margaret Aw
World Journal of Gastroenterology.2022; 28(17): 1830. CrossRef
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The Korean Journal of Internal Medicine.2022; 37(5): 885. CrossRef
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Diagnostics.2021; 11(11): 2123. CrossRef

13,263 View
246 Download
24 Web of Science
22 Crossref

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