J Calvin Coffey

Prof Surgery, University Hospital Limerick, UL, Limerick/Ireland,TEDx, UCC Alumnus Award, Bengt Ihre Medal, James IV award, UCC Medical School Medal

[Ali Cihat Yildirim @dralicihat]

Mid- to Long-Term Outcomes of the MESOCOLIC Trial Evaluating Extensive vs Limited Mesenteric Excision in Crohn's Disease.
Duan M, Zhang X, Liu W, et al. Gastroenterology. 2026;171(3):556-559. doi:10.1053/j.gastro.2026.05.004

[J Calvin Coffey @Johncalvincoffe]

Editor’s Essential Reading

September issue — Gastroenterology

Selected as Essential Reading

Now FREE ONLINE

Mid- to Long-Term Outcomes of the MESOCOLIC Trial Evaluating Extensive vs Limited Mesenteric Excision in Crohn’s Disease - Gastroenterology https://t.co/aVsRvx1H3q

[Gastroenterology @AGA_Gastro]

🌟 The September Editor's Essential Reading examines mid- to long-term outcomes of the MESOCOLIC trial evaluating extensive vs limited mesenteric excision in #CrohnsDisease. Learn more at https://t.co/7BxY8xvOcl

[J Calvin Coffey @Johncalvincoffe]

Disturbance of Oxylipin Metabolism .....in Crohn’s Disease - Cellular and Molecular Gastroenterology and Hepatology https://t.co/jcz10jxtbG

Excellent study which "reveal the mechanism of mesentery-gut axis on the pathogenisis of colitis"

[J Calvin Coffey @Johncalvincoffe]

🚨 Now free to read in GASTROENTEROLOGY

The MESOCOLIC trial delivers a striking surgical message for Crohn’s disease:

Severe endoscopic recurrence - minimal when the mesentery was included as part of the resection.

🔗 Free access:
https://t.co/9LYhlNpyTd

[J Calvin Coffey @Johncalvincoffe]

Nature Reviews Gastroenterology&Hepatology

Full article

https://t.co/XQ8TMmyHw3

@NatRevGastroHep @JAMASurgery @Nature @LancetGastroHep @NEJM @RCSI_Irl @MedicineAtUL @SWexner @juliomayol @DCREdInChief

[Giovanni Marchegiani @Gio_Marchegiani]

Mesopancreas excision ✂️ International consensus

🗺️ Defined as retropancreatic compartment of lymphatic neurovascular and adipose tissue

👍 Both artery- and mesenteric-first approach OK

🧼 Total excision more curative?! to be investigated further

https://t.co/n3laFwAe77

[Walter Suárez Carmona @a_fisiolog57853]

EL MODELO MESENTÉRICO DE ANATOMÍA ABDOMINAL

¡¡¡A leer, zagales!!!

Link en mi bio

o

https://t.co/CtLFk9mSW8

[Seoul National University Hospital @snuh_official]

Cancer surgery can damage lymphatic vessels, causing leaks that are hard to locate — especially in the liver & mesentery, which produce 70%+ of all lymph but are nearly invisible on standard scans. 🧵

[Adipose Papers @adipose_papers]

Bidirectional communication between neurons in the mesentery and ileal myenteric neurons https://t.co/Q4bJgom5g0

[Nature Reviews Gastroenterology & Hepatology @NatRevGastroHep]

New online! The mesenteric model of abdominal anatomy https://t.co/9lKCFJENij

[J Calvin Coffey @Johncalvincoffe]

@mbehr_mcgill These are now the big questions. The translational investigation of the mesentery is red hot at the moment with publications in Cell, J Ex Med, Nat Reviews G&H, Nat Comms, Gastroenterology all illuminating the field

[J Calvin Coffey @Johncalvincoffe]

Congratulations to authors!

Extended Mesenteric Resection associated with reduced surgical recurrence in Crohn's disease

-the only factor independantly protective against surgical recurrence

PDF at https://t.co/aSYW94sTEs

download, translate with Chat, read

[ESR Journals @ESRJournals]

Assessment of intestinal fibrosis is an unmet need for patients with Crohn's disease, but spatial heterogeneity of fibrosis may affect accurracy. The authors developed and validated a novel strategy based on subregionalisation into mesenteric and antimesenteric borders on MRE (Luyao Wu et al.)

https://t.co/azT9BTgj6M

[Malcolm Tan @IBDGastroDocSg]

10/ Suggested take-aways
- However, if dealing with advanced B2/B3 phenotypes, a radical oncologic resection clearing the ileocolic pedicle (MESOCOLIC) alters long-term disease course and delays biologic dependency.

[Malcolm Tan @IBDGastroDocSg]

9/ Suggested take-aways
- A less extensive mesenteric wedge resection that leaves the vascular trunk intact (SPICY) will not alter your recurrence rates at 6 months.

[Malcolm Tan @IBDGastroDocSg]

8/ Why the different results?
- Radicality: SPICY’s approach left central/trunk mesentery in situ. MESOCOLIC completely cleared the nodal and neural transit zones along the ileocolic trunk.
- Patient Selection: MESOCOLIC targeted advanced, fibrotic disease (B2/B3) in non-smokers.

[Malcolm Tan @IBDGastroDocSg]

7/ Outcomes
- SPICY reported a negative result at 6 months, while MESOCOLIC demonstrated a massive, durable benefit to extensive mesenteric excision (EME)

[J Calvin Coffey @Johncalvincoffe]

@IBDGastroDocSg Leaving an exudative ileocolic pedicle leaves residual disease, leaves a lot of immunological armentarium in a residual, hostile, mesentery - collections and leaks are likely to follow

[Malcolm Tan @IBDGastroDocSg]

5/ Anastomosis
- SPICY rigidly standardized to wide-stapled, side-to-side configurations (mostly antiperistaltic).
- MESOCOLIC left configuration to surgeon preference using a linear stapler (mostly isoperistaltic).