Mesenteric Resection in Crohn’s Disease

Operation and reoperation rates for Crohn’s disease remain unacceptably high. This is despite intensive scientific and clinical investigation for several decades. Recent clinical findings indicate that inclusion of the mesentery during surgery for Crohn’s disease, may be associated with reduced requirement for re-operation. At the least, the findings indicate that resection of the mesentery is associated with slowing of disease progression. Several clinical trials have commenced aimed at further determining the effects of inclusion of the mesentery during resection. In tandem with these, several groups have identified pathobiologic links between mesenteric cellular/molecular events, and intestinal manifestations of Crohn’s disease. Collectively the findings indicate the mesentery plays a pathobiologic role in Cohn’s disease and that alterations of mesenteric inputs (whether these by surgical or pharmaco-therapeutic means) will provide novel and beneficial therapeutic strategies.