Clin Colon Rectal Surg 2022; 35(04): 321-327
DOI: 10.1055/s-0042-1743590
Review Article

Intriguing Role of the Mesentery in Ileocolic Crohn's Disease

Giulia Turri
1   Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
2   Department of Surgical Sciences, Dentistry, Gynecology, and Pediatrics, Division of General and Hepatobiliary Surgery, University of Verona, Verona, Italy
,
Michele Carvello
1   Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
,
Nadav Ben David
1   Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
,
Antonino Spinelli
1   Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
3   Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
› Author Affiliations

Abstract

Crohn's disease (CD) is a chronic relapsing inflammatory bowel disease with unknown etiology. Up to 80% of patients will eventually require surgery throughout their lifetime, and often repeated resections are required for disease recurrence. Observations of “creeping fat” surrounding the diseased intestine renewed interest in the mesentery, recently defined as an organ with endocrine and immune functions. According to the inside-out model, the mesentery may be primarily affected in CD and subsequent cause alterations in the mucosa. Recently, lower surgical recurrence rates have been reported with en-bloc excision of the mesentery adjoining the diseased intestine. Results of ongoing randomized controlled trials may clarify the role of the mesentery in CD and possibly lead to its adoption as standard during surgery for Crohn's disease.



Publication History

Article published online:
13 April 2022

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