Early ileocecal resection vs infliximab: quality of life evidence

What is known

• The LIR!C RCT compared laparoscopic ileocaecal resection with infliximab specifically to assess health-related quality of life and found them comparable. ¹
• Long-term follow-ups report similar quality-of-life outcomes and analyze durability of treatment effect and remission at extended timepoints. ^2,3
• The 10-year follow-up is a retrospective extension of the original RCT rather than a prospectively randomized long-term QoL comparison. ³

What is unknown / caveats

• Long-term outcomes rely on retrospective follow-up extensions, not prospective randomized QoL capture
• Trial cohort was uncomplicated terminal ileitis. Complicated/penetrating and older patients not represented here
• The retrieved excerpts do not report QoL data stratified by complicated phenotype, fibrosis burden, or age, so those subgroups remain the true gap.

References

1. Ponsioen CY, de Groof EJ, Eshuis EJ, Gardenbroek TJ, Bossuyt PMM, Hart A, Warusavitarne J, Buskens CJ, van Bodegraven AA, Brink MA, Consten ECJ, van Wagensveld BA, Rijk MCM, Crolla RMPH, Noomen CG, Houdijk APJ, Mallant RC, Boom M, Marsman WA, Stockmann HB, Mol B, de Groof AJ, Stokkers PC, D'Haens GR, Bemelman WA, LIR!C study G. Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn's disease: a randomised controlled, open-label, multicentre trial. Lancet Gastroenterol Hepatol. 2017;2(11):785-792. PMID: 28838644.

2. Stevens TW, Haasnoot ML, D'Haens GR, Buskens CJ, de Groof EJ, Eshuis EJ, Gardenbroek TJ, Mol B, Stokkers PCF, Bemelman WA, Ponsioen CY, LIR!C study G. Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn's disease: retrospective long-term follow-up of the LIR!C trial. Lancet Gastroenterol Hepatol. 2020;5(10):900-907. PMID: 32619413.

3. Oldenburg L, Haanappel AEG, Ali M, Bosman C, Buskens CJ, Ponsioen CY, D'Haens GR, Bemelman WA, LIR!C study G. Ileocaecal resection versus infliximab for ileal Crohn's disease: retrospective 10-year follow-up of the LIR!C trial. Lancet Gastroenterol Hepatol. 2026;11(4):314-322. PMID: 41724174.

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Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct.