Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2025; 17(8): 106455
Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.106455
Intestinal fibrosis attenuates the prophylactic effect of anti-tumour necrosis factor therapy on the postoperative recurrence of Crohn’s disease
Ze-Yu Ding, Yu-Jie Wang, Dan-Hua Yao, Tao Tian, Yu-Hua Huang, You-Sheng Li
Ze-Yu Ding, Dan-Hua Yao, Tao Tian, Yu-Hua Huang, You-Sheng Li, Department of General Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People’s Hospital, Shanghai 200023, China
Yu-Jie Wang, Department of Pharmacy, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People’s Hospital, Shanghai 200023, China
Author contributions: Ding ZY, Wang YJ, Yao DH, Tian T, Huang YH, and Li YS participated in the conceptualization of the study; Huang YH and Li YS designed the study; Ding ZY and Wang YJ acquired the data and performed statistical analysis; Ding ZY contributed to the drafting of the article. All authors contributed to interpreting the data, revised the article and approved the final version of the article.
Supported by the National Natural Science Foundation of China, No. 82200621; and the Original Research Projects, Shanghai Ninth People’s Hospital, No. 2022LHA08 and No. YBKB202220.
Institutional review board statement: All procedures performed in these studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the ethics committee of Ninth People’s Hospital Affiliated Shanghai Jiao Tong University School of Medicine (Approval No. SH9H-2022-T423-1).
Informed consent statement: Informed consent was obtained from all individual patients included in the study.
Conflict-of-interest statement: This study was financially supported by grants from the National Natural Science Foundation of China, Original Research Projects, Shanghai Ninth People’s Hospital and the Industrial Support Foundation, Science and Technology Commission of Shanghai Municipality. The funding body had no role in the study design, data collection, analysis, interpretation or writing of the manuscript. All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: You-Sheng Li, MD, PhD, Professor, Department of General Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People’s Hospital, No. 639 Zhizaoju Road, Huangpu District, Shanghai 200023, China. gisurgery9@126.com
Received: February 27, 2025
Revised: April 11, 2025
Accepted: June 25, 2025
Published online: August 27, 2025
Processing time: 180 Days and 6.3 Hours
Core Tip

Core Tip: In a real-world cohort of Crohn’s disease patients with curative ileocecal resection, endoscopic postoperative recurrence (POR), radiographical POR and surgical POR rates were 52.6%, 41.2%, and 10.8%, respectively. Intestinal fibrosis increased the risk of radiographical POR and surgical POR despite biologic prophylaxis. After adjusting for disease severity, fibrosis was significantly associated with accelerated rPOR progression. Higher serum trough levels may delay endoscopic POR onset. These findings highlight the need for improved treatments for patients with Crohn’s disease with prolonged disease and fibrosis.