Submucosal Plexitis as a Predictor of Postoperative Surgical Recurrence in Crohnʼs Disease

Abstract

Early surgical revision and submucosal plexitis in proximal margins of ileocolonic resection specimens are independently associated with CD surgical recurrence.

Increased enteric glial cells in proximal margin of resection is associated with postoperative recurrence of Crohn's disease

“…Previous work failed to demonstrate that disease‐free proximal resection margins are a protective feature against the recurrence of inflammation; interestingly, our data indicated that increased density of S100‐positive EGCs in disease‐free margin is associated with postoperative recurrence. It has been found by several studies that plexitis was implicated in the postoperative endscopic, clinical, and surgical recurrence of CD . We demonstrated here for the first time that an increase in S100‐positive enterogial cells at a site devoid of inflammation may be predictor of postoperative disease recurrence.…”

“…It has been found by several studies that plexitis was implicated in the postoperative endscopic, clinical, and surgical recurrence of CD. 11,15,29,41 We demonstrated here for the first time that an increase in S100positive enterogial cells at a site devoid of inflammation may be predictor of postoperative disease recurrence. This may partly explain that the extensive bowel resection is not protective from disease recurrence in anastomosis.…”

“…We focused our study on histological analysis of the proximal resection margin because CD recurrence tends to take place in the previously healthy ileum . This study focused on the ENS because plexitis in the proximal margin is associated with early postoperative recurrence . Neural involvement in CD is illustrated by nerve damage and changes including hyperplasia of the ganglion cells, extensive axonal degeneration, changes in gut neuropeptide content, and plexitis .…”

“…3,[26][27][28] This study focused on the ENS Enteric glial cells and recurrent CD because plexitis in the proximal margin is associated with early postoperative recurrence. 7,15,29,30 Neural involvement in CD is illustrated by nerve damage and changes including hyperplasia of the ganglion cells, extensive axonal degeneration, changes in gut neuropeptide content, and plexitis. [31][32][33][34] Data on the SP levels in CD is controversial, 17,35,36 and conflict results have been reported in VIP-positive nerves, 19,20,37,38 suggesting that the role of structural ENS as well as neuropeptide remains elusive.…”

Post-operative recurrence in Crohn's disease. Critical analysis of potential risk factors. An update

“…The Authors showed that early surgical revision after the first ileocecal resection (hazard ratio ¼ 9.56; 95% confidence interval, 2.02e45.19; P ¼ 0.0046), presence of submucosal plexitis (HR ¼ 8.02; 95% CI, 1.87e34.47; P ¼ 0.0054), and presence of more than 6 lymphocytes in the submucosal plexus (HR ¼ 5.84; 95% CI, 1.23e27.65; P ¼ 0.0269) were independently associated with risk of surgical recurrence. 81 …”