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GPX4 Expression After Kono-S vs Conventional Anastomosis

NCT07772037

Not Yet RecruitingN/A

Sponsor: East Kent Hospitals University NHS Foundation Trust

Conditions: Chrohn's Disease

Countries: United Kingdom

Crohn's disease is a long-term condition that causes inflammation in the bowel. Many people with Crohn's will need surgery at some point to remove damaged sections of intestine. Although surgery can improve symptoms, the disease often comes back near the join (anastomosis) where the bowel has been reconnected. Surgeons use different techniques to reconnect the bowel. One newer approach, called the Kono-S anastomosis, is designed to reduce the risk of Crohn's disease returning. Early results are promising, but it is still not fully understood why it may work better than traditional methods. This project aims to explore how the bowel heals after surgery by looking at oxidative stress, a type of tissue damage caused by an imbalance of harmful molecules in the body. The investigators will focus on a protective protein called glutathione peroxidase-4 (GPX4), an anti-oxidative enzyme that reduces oxidized phospholipids in biomembranes. By analysing tissue samples taken before and after surgery, the investigators will compare patients who had the Kono-S technique with those who had standard surgical joins. The investigators want to see whether differences in healing at a microscopic level could explain why some patients do better than others. The findings from this study could: * Improve understanding of why Crohn's disease comes back after surgery. * Help surgeons choose the best technique for each patient. * Support the development of new treatments aimed at improving healing. Ultimately, this research aims to reduce the risk of disease recurrence and improve long-term outcomes for people living with Crohn's disease.

Eligibility overview

Sex: ALL

Age: 18 Years to —

Healthy volunteers: No

Study type: OBSERVATIONAL

Eligibility criteria

Inclusion Criteria:• Adults (≥18 years) with confirmed Crohn's disease who underwent ileocolic or small bowel resection with a primary anastomosis.

* Documented anastomotic configuration (Kono-S or conventional).
* Availability of archived pathology material from the resection specimen containing the anastomotic site.
* At least one additional tissue timepoint available: preoperative endoscopic biopsy or follow up endoscopic biopsy within 24 months.
* Available postoperative endoscopic follow up data (Rutgeerts score) where applicable.

Exclusion Criteria:

* • Indeterminate colitis or non-Crohn's pathology on histology.

  * Lack of retrievable tissue or poor tissue quality (e.g., extensive necrosis or autolysis) precluding IHC.
  * Unclear anastomotic type.
  * Absence of epithelial component in the available tissue (e.g., only serosa or fibrofatty tissue).
  * Major confounders that could affect GPX4 expression, such as severe ischaemia, uncontrolled sepsis, or immediate reoperation at the anastomotic site.
  * Patients with permanent stomas and no anastomotic follow up where interpretation would be ambiguous.

Locations (1)

Margate, Kent, United Kingdom