Top 100 Most Disruptive

The 100 most-disruptive papers by the Funk & Owen-Smith CD (disruption) index, which measures how much a paper redirected the field away from prior work.

Curated by · Professor of Surgery, Department of Colon & Rectal Surgery, Cleveland Clinic · Corpus last refreshed · Publications

Ranked from the perianal & luminal Crohn's-disease literature.

The disruption index is unreliable for papers published within the last 5 years — the forward-citation window is too short to score them — so recent papers are excluded from this ranking. A research reference for clinicians and trainees, not treatment advice.

#PaperAltmetricCD index
1Ileostomy in pregnancy.
Hudson · 1972 · Proc R Soc Med
+0.737
36 cites
2Predicting Outcomes in Pediatric Crohn's Disease for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease-Ahead Program.
Ricciuto A · 2021 · Gastroenterology
+0.418
77 cites
3American Gastroenterological Association medical position statement: perianal Crohn's disease.
American Gastroenterological Association Clinical Practice Committee · 2003 · Gastroenterology
+0.325
134 cites
4Treatment of haemorrhoids in patients with inflammatory bowel disease.
Jeffery PJ · 1977 · Lancet
+0.295
70 cites
5Occurrence and outcome after primary treatment of anal fistulae in Crohn's disease.
Hellers · 1980 · Gut
+0.292
364 cites
6Results of a survey to evaluate whether vaginal delivery and episiotomy lead to perineal involvement in women with Crohn's disease.
Brandt LJ · 1995 · Am J Gastroenterol
+0.225
74 cites
7An Update on the Medical Management of Inflammatory Pouch Complications
Quinn · 2020 · Am J Gastroenterol
+0.221
30 cites
8Anorectal tuberculosis.
Logan VS · 1969 · Proc R Soc Med
+0.208
66 cites
9The role of colonoscopy in the differential diagnosis of inflammatory bowel disease.
Waye JD · 1977 · Gastrointest Endosc
+0.185
74 cites
10The effects of diversion of intestinal contents on the progress of Crohn's disease of the large bowel.
Burman JH · 1971 · Gut
+0.141
93 cites
11High serum tumor necrosis factor-alpha levels are associated with lack of response to infliximab in fistulizing Crohn's disease.
Martínez-Borra J · 2002 · Am J Gastroenterol
+0.138
93 cites
12Repair of persistent perineal sinuses by means of a pedicle flap of musculus gracilis. Case report.
Bartholdson · 1975 · Scand J Plast Reconstr Surg
+0.135
41 cites
13Symposium. Crohn's disease: anal lesions.
Lockhart-Mummery HE · 1975 · Dis Colon Rectum
+0.116
76 cites
14The fate of ileorectal anastomosis in Crohn's disease.
Burman · 1971 · Gut
+0.104
57 cites
15The extra-intestinal complications of Crohn's disease and ulcerative colitis: a study of 700 patients.
Greenstein · 1976 · Medicine (Baltimore)
+0.099
1,063 cites
16Anal complications in Crohn's disease.
Williams DR · 1981 · Dis Colon Rectum
+0.095
156 cites
17Primary closure of perineal wound after proctocolectomy or rectal excision.
Hultén · 1971 · Acta Chir Scand
+0.093
36 cites
18Preliminary experience with laparoscopic intestinal surgery for Crohn's disease.
Ludwig · 1996 · Am J Surg
+0.084
99 cites
19Laparoscopic surgery for inflammatory bowel disease
Liu · 1995 · Am Surg
+0.078
45 cites
20Results of surgery for inflammatory bowel disease: a further survey of one hospital region.
Ritchie · 1974 · Br Med J
+0.069
53 cites
21Computed tomography in Crohn's disease.
Berliner L · 1982 · Am J Gastroenterol
+0.062
45 cites
22Effect of faecal stream diversion on recurrence of Crohn's disease in the neoterminal ileum.
Rutgeerts · 1991 · Lancet
+0.060
598 cites
23PLACE OF A DOUBLE-BARRELLED ILEOSTOMY IN ULCERATIVE COLITIS AND CROHN'S DISEASE OF THE COLON: A PRELIMINARY REPORT.
TRUELOVE · 1965 · Br Med J
+0.056
66 cites
24Classification and management of postsurgical anal stenosis.
Milsom JW · 1986 · Surg Gynecol Obstet
+0.049
55 cites
25A surgical subspecialist enhances general surgical operative experience
Galandiuk · 1995 · Arch Surg
+0.049
25 cites
26Surgical pathology and management of anorectal Crohn's disease.
Hughes LE · 1978 · J R Soc Med
+0.046
104 cites
27Natural history of perianal Crohn's disease. Ten year follow-up: a plea for conservatism.
Buchmann P · 1980 · Am J Surg
+0.046
152 cites
28Results of the pelvic-pouch procedure in patients with Crohn's disease.
Deutsch A · 1991 · Dis Colon Rectum
+0.044
132 cites
29Early complications following surgical treatment for Crohn's disease.
Heimann · 1985 · Ann Surg
+0.042
77 cites
30Problems encountered with the Kock ileostomy.
Flake WK · 1979 · Am J Surg
+0.042
26 cites
31Prospective study of the features, indications, and surgical treatment in 513 consecutive patients affected by Crohn's disease.
Hurst RD · 1997 · Surgery
+0.040
80 cites
32Antibiotics for inflammatory bowel disease: do they work?
Guslandi · 2005 · Eur J Gastroenterol Hepatol
+0.039
37 cites
33Role of the faecal stream in the maintenance of Crohn's colitis.
Harper PH · 1985 · Gut
+0.037
160 cites
34Tc-99m HMPAO-labeled leukocyte scintigraphy with hybrid SPECT/CT detects perianal fistulas in Crohn disease.
Filippi L · 2006 · Clin Nucl Med
+0.036
23 cites
35Colovesical and rectovesical fistulas.
King RM · 1982 · Arch Surg
+0.036
41 cites
36Radiologic and clinical assessment of broad-spectrum antibiotic therapy in Crohn's disease.
Moss AA · 1978 · AJR Am J Roentgenol
+0.033
63 cites
37Crohn's disease of the colon and its distinction from diverticulitis.
Schmidt GT · 1968 · Gut
+0.032
94 cites
38Anorectal Crohn's disease: definitive surgery for fistulas and recurrent abscesses.
Sohn N · 1980 · Am J Surg
+0.032
85 cites
39Preoperative nutritional status and other factors that influence surgical outcome in patients with Crohn's disease.
Lindor · 1985 · Mayo Clin Proc
+0.031
40 cites
40Changes in the bidirectional sodium flux across the intestinal mucosa in Crohn's disease.
Allan · 1975 · Gut
+0.030
48 cites
41Long-term ileostomy complications in patients with ulcerative colitis and Crohn's disease.
Carlstedt · 1987 · Int J Colorectal Dis
+0.029
57 cites
42Sexual dysfunction amongst women with Crohn's disease: a hidden problem.
Moody G · 1992 · Digestion
+0.026
66 cites
43Life-table analysis of stomal complications following ileostomy.
Leong · 1994 · Br J Surg
+0.026
132 cites
44Carcinoma in a rectovaginal fistula in a patient with Crohn's disease.
Buchmann P · 1980 · Am J Surg
+0.025
56 cites
45Crohn's disease of the colon. I. Fistula in Crohn's disease of the colon, classification presenting features and management in 63 patients.
Greenstein AJ · 1974 · Am J Gastroenterol
+0.024
87 cites
46Pharmacokinetics of metronidazole in patients with enteric disease compared to normal volunteers.
Bergan T · 1981 · Chemotherapy
+0.024
37 cites
47Indications for surgery in Crohn's disease: analysis of 500 cases.
Farmer · 1976 · Gastroenterology
+0.023
161 cites
48Gynaecological problems related to anatomical changes after conventional proctocolectomy and ileostomy
Wikland · 1990 · Int J Colorectal Dis
+0.023
61 cites
49Crohn's disease in the elderly
Tchirkow · 1983 · Dis Colon Rectum
+0.022
41 cites
50Do anal fistulas in Crohn's disease behave differently and defy Goodsall's rule more frequently than fistulas that are cryptoglandular in origin?
Coremans G · 2003 · Am J Gastroenterol
+0.021
28 cites
51Rectovaginal fistula in patients with colitis: review and report of a case.
Faulconer HT · 1975 · Dis Colon Rectum
+0.021
25 cites
52Axonal damage in Crohn's disease is frequent, but non-specific.
Brewer DB · 1990 · J Pathol
+0.020
22 cites
53Grafting the unhealed perineal wound after coloproctectomy for Crohn disease.
Anderson R · 1976 · Arch Surg
+0.020
47 cites
54Ileal pouch-anal anastomosis. Patterns of failure
Gemlo · 1992 · Arch Surg
+0.020
126 cites
55Impotence after proctectomy for inflammatory disease of the bowel.
Corman · 1978 · Dis Colon Rectum
+0.020
21 cites
56Colovaginal fistulas. Etiology and management.
Bahadursingh AM · 2003 · J Reprod Med
+0.019
33 cites
57Anal tuberculosis: report of two cases and literature review.
Harland RW · 1992 · Am J Gastroenterol
+0.019
27 cites
58Healing of perineal Crohn's disease with metronidazole.
Bernstein LH · 1980 · Gastroenterology
+0.018
59 cites
59Perianal disease in children and adolescents with Crohn's disease.
Markowitz J · 1984 · Gastroenterology
+0.018
54 cites
60Ileostomy without external appliances: a survey of 25 patients provided with intra-abdominal intestinal reservoir.
Kock · 1971 · Ann Surg
+0.017
105 cites
61First off-the-shelf mesenchymal stem cell therapy nears European approval.
Sheridan C · 2018 · Nat Biotechnol
+0.017
22 cites
62Anal lesions complicating Crohn disease.
Homan WP · 1976 · Arch Surg
+0.016
48 cites
63Perianal complications of pediatric Crohn's disease.
Palder SB · 1991 · J Pediatr Surg
+0.016
54 cites
64The normal flora of ileostomy and transverse colostomy effluents.
Finegold · 1970 · J Infect Dis
+0.016
66 cites
65Long-term prognosis for patients with ulcerative proctosigmoiditis (ulcerative colitis confirmed to the rectum and sigmoid colon).
Farmer RG · 1979 · J Clin Gastroenterol
+0.015
35 cites
66Perianal Crohn's disease.
Alexander-Williams J · 1980 · World J Surg
+0.015
55 cites
67Laparoscopic creation of stomas.
Oliveira L · 1997 · Surg Endosc
+0.014
66 cites
68Modified two-stage ileal pouch-anal anastomosis: equivalent outcomes with less resource utilization
Swenson · 2005 · Dis Colon Rectum
+0.014
57 cites
69A phase I clinical trial of the treatment of Crohn's fistula by adipose mesenchymal stem cell transplantation.
García-Olmo D · 2005 · Dis Colon Rectum
+0.013
587 cites
70Treatment of fistulas with granulocyte colony-stimulating factor in a patient with Crohn's disease.
Vaughan D · 1999 · N Engl J Med
+0.013
52 cites
71Fate of the pouch in 151 pediatric patients after ileal pouch anal anastomosis
Alexander · 2003 · J Pediatr Surg
+0.012
99 cites
72Ileo-rectal anastomosis for Crohn's disease of the colon.
Baker · 1971 · Gut
+0.012
48 cites
73Laparoscopic surgery for lower gastrointestinal fistulas
Joo · 1997 · Surg Endosc
+0.011
46 cites
74Outcome of laparoscopic colorectal surgery in older patients.
Reissman · 1996 · Am Surg
+0.011
65 cites
75Acute surgical emergencies in inflammatory bowel disease.
Berg · 2002 · Am J Surg
+0.011
95 cites
76Surgical therapy for ulcerative colitis and Crohn's disease.
Becker · 1999 · Gastroenterol Clin North Am
+0.011
86 cites
77Diagnosis of fistulae and sinus tracts in patients with Crohn disease: value of MR imaging.
Koelbel G · 1989 · AJR Am J Roentgenol
+0.011
128 cites
78Outcome of "indeterminant" colitis following ileal pouch-anal anastomosis
Pezim · 1989 · Dis Colon Rectum
+0.011
103 cites
79Paraileostomy hernia: a clinical and radiological study.
Williams · 1990 · Br J Surg
+0.011
76 cites
80Quality of life in perianal Crohn's disease: what do patients consider important?
Mahadev S · 2011 · Dis Colon Rectum
+0.011
106 cites
81Proctocolectomy is associated with a higher complication rate but carries a lower recurrence rate than total colectomy and ileorectal anastomosis in Crohn colitis.
Yamamoto · 1999 · Scand J Gastroenterol
+0.010
45 cites
82Major Abdominal and Perianal Surgery in Crohn's Disease: Long-term Follow-up of Australian Patients With Crohn's Disease.
Toh JWT · 2018 · Dis Colon Rectum
+0.010
34 cites
83Anal complications after restorative proctocolectomy (J-pouch)
Rossi · 2002 · Am Surg
+0.010
23 cites
84The histology of anal skin tags in Crohn's disease: an aid to confirmation of the diagnosis.
Taylor BA · 1989 · Int J Colorectal Dis
+0.010
20 cites
85Laparoscopic surgery for Crohn's disease: reasons for conversion.
Schmidt · 2001 · Ann Surg
+0.010
77 cites
86Does Crohn's disease need differentiation from tuberculosis?
Jayanthi V · 1996 · J Gastroenterol Hepatol
+0.010
38 cites
87Factors predictive of persistent or recurrent Crohn's disease in excluded rectal segments.
Guillem J · 1992 · Dis Colon Rectum
+0.010
36 cites
88Highly destructive perianal disease in children with Crohn's disease.
Markowitz J · 1995 · J Pediatr Gastroenterol Nutr
+0.009
34 cites
89Expansion of human mesenchymal stem/stromal cells (hMSCs) in bioreactors using microcarriers: lessons learnt and what the future holds.
Silva Couto P · 2020 · Biotechnol Adv
+0.009
47 cites
90Ulcerative colitis as a progressive disease: the forgotten evidence.
Torres J · 2012 · Inflamm Bowel Dis
+0.009
241 cites
91Magnesium deficiency after ileal resections for Crohn's disease.
Hessov · 1983 · Scand J Gastroenterol
+0.009
47 cites
92Stricture of the anorectum in Crohn's disease involving the colon.
Greenstein · 1975 · Ann Surg
+0.009
21 cites
93Clinical classification of perianal Crohn's disease.
Hughes LE · 1992 · Dis Colon Rectum
+0.008
119 cites
94Long-term follow-up of patients with Crohn's disease. Relationship between the clinical pattern and prognosis.
Farmer RG · 1985 · Gastroenterology
+0.008
428 cites
95Crohn's disease mimicking sarcoidosis in bronchoalveolar lavage.
Bewig B · 1999 · Respiration
+0.008
20 cites
96Predictors of Crohn's disease.
Beaugerie L · 2006 · Gastroenterology
+0.008
714 cites
97Recent trends in the surgical management of inflammatory bowel disease
Roses · 2008 · World J Gastroenterol
+0.008
26 cites
98Healing of severe perineal and cutaneous Crohn's disease with hyperbaric oxygen.
Brady CE · 1989 · Gastroenterology
+0.008
85 cites
99Healing of perineal Crohn's disease with metronidazole.
Bernstein LH · 1980 · Gastroenterology
+0.008
326 cites
100An audit of restorative proctocolectomy
Keighley · 1993 · Gut
+0.008
58 cites