Risk factors for early postoperative complications in patients with Crohn’s disease after colorectal surgery other than ileocecal resection or right hemicolectomy

2018 ◽  
Vol 34 (2) ◽  
pp. 293-300 ◽  
Author(s):  
Christian Galata ◽  
Peter Kienle ◽  
Christel Weiss ◽  
Steffen Seyfried ◽  
Christoph Reißfelder ◽  
...  
2014 ◽  
Vol 31 (3) ◽  
pp. 147-154 ◽  
Author(s):  
Vladimir Joksimović ◽  
Aleksandar Karagjozov ◽  
Gjorgi Jota ◽  
Ilija Milev ◽  
Radomir Gelevski

Summary The aim of this study was to show the influence of various risk factors on early postoperative complications following surgery for Crohn’s disease (CD). In this review, an online internet database was searched, and also systematic review of the literature was performed. Three different studies from different countries were analyzed and compared with the results obtained in our University Clinic of Digestive Surgery - Skopje. The first review shows the influence of positive resection margins in CD on septical complications occurrence in patients undergoing ileocolic resection for CD at the Tel Aviv Medical Centre - Israel. The second review shows the risk factors for complications after bowel surgery in Korean patients with CD using data from the Asan Medical Centre - Seul, Korea. The third review shows that the delay of surgery is associated with inferior postoperative outcome in patients treated for perforating Crohn’s ileitis, and the study was conducted using data from the medical records of patients treated at the Department of Surgery at the University of Regensburg, Germany. Finally, we analyzed the influence of the most common risk factors on early postoperative complications in patients that underwent surgery for Crohn’s disease in a five-year period at the University Clinic of Digestive Surgery in Skopje, Macedonia and compared them with the results in the aforementioned articles.


2013 ◽  
Vol 144 (5) ◽  
pp. S-1084
Author(s):  
Michael S. Kasparek ◽  
Sophie Zehl ◽  
Mario Mueller ◽  
Stephan Brand ◽  
Martin E. Kreis

Author(s):  
K. Horisberger ◽  
D. L. Birrer ◽  
A. Rickenbacher ◽  
M. Turina

Abstract Purpose The most frequent long-term complication after ileocecal resection in Crohn’s disease is anastomotic recurrence and subsequent stenosis. Recurrence typically begins at the site of the anastomosis, raising the question of whether the surgical technique of the anastomosis could affect recurrence rates. Kono-S anastomosis is a hand-sewn antimesenteric functional end-to-end anastomosis that offers a wide lumen that is well accessible for endoscopic dilatation. The purpose of our study is to review the rate of postoperative complications almost 2 years after the introduction of this technique. Materials and methods This is a prospective single-center cohort study of all consecutive patients with Crohn’s disease undergoing ileocecal resection. Patients’ characteristics as well as specific data for the surgical procedure and short-term outcome were evaluated. Results Thirty patients were operated for Crohn’s disease of the terminal ileum (n = 24) or anastomotic recurrence (n = 6). Postoperative complications with a Clavien-Dindo Score ≥ IIIb were observed in three patients. One patient showed a hemorrhage and underwent surgical hemostasis. Two patients developed anastomotic leakage; in both cases, ileostomy was created after resection of the anastomosis. The median hospital stay was 9 days (IQR 7–12). A comparison with a historic group of conventionally operated patients of our hospital revealed no differences in short-term results except for the duration of surgery. Conclusion The Kono-S anastomosis is associated with acceptable short-term results, complications, and recurrence rates comparable with the established anastomotic techniques. Longer operation times are observed, but the few published studies concerning long-term recurrence are promising.


2018 ◽  
Vol 55 (3) ◽  
pp. 252-257 ◽  
Author(s):  
Rogério SAAD HOSSNE ◽  
Ligia Yukie SASSAKI ◽  
Julio Pinheiro BAIMA ◽  
José Donizeti de MEIRA JÚNIOR ◽  
Luana Moraes CAMPOS

ABSTRACT BACKGROUND: The post-operative complications rate is greater in patients with Crohn’s disease than in other abdominal surgeries due to other benign conditions. Prevention and management of such complications are important factors in the care of these patients. OBJECTIVE: The objectives of this research are to analyze the rate of postoperative complications and the major risk factors in patients with Crohn’s disease. METHODS: A descriptive and retrospective study based on analysis of medical records of patients with Crohn’s disease undergoing ileal and/or colonic resection, which analyzed the main surgical complications and their major risk factors. RESULTS: Forty-four surgical procedures and thirty-seven patients were analyzed. Most were female (56.7%). Postoperative complications were observed in 18 (40.9%) surgeries. The disease duration (P=0.04), the penetrating behavior (P=0.013), the time between diagnosis and the first surgery (P=0.04), malnutrition with low body mass index (BMI), duration of surgery (P=0.016), and the size of the removed specimen (P=0.014) were associated with higher rates of complications. The use of drugs blocking tumor necrosis factor up to eight weeks before surgery was not significantly associated with higher complications rates or increased need for reoperation. CONCLUSION: The complication rate observed in this study is similar to published data. The duration of the disease, the penetrating behavior, the size of the removed specimen, the duration of the surgery, and BMI are important risk factors for perioperative complications in Crohn’s disease.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S101-S102
Author(s):  
M Rottoli ◽  
M Tanzanu ◽  
G Vago ◽  
A Belvedere ◽  
D Parlanti ◽  
...  

Abstract Background Several risk factors for morbidity after surgery for Crohn’s disease of the terminal ileum have already been identified. However, the study population is rarely homogeneous, due to high-volume centres receiving patients treated in other hospitals with diverging medical protocols and different thresholds for surgical referral. A study including only patients undergoing homogeneous perioperative treatment in a single referral centre might reduce the selection bias. The aim of this study was to identify the risk factors for minor (Clavien-Dindo ≤2) and major (Clavien-Dindo ≥3) postoperative complications in patients who received medical treatment and surgery in a single centre. Methods Retrospective analysis of ileocecal resections for Crohn’s disease in biological era (2004–2019). Recurrence was excluded. Risk factors for minor and major complications were identified through univariate and multivariable logistic regression analyses. Variables were selected by univariate analysis with p < 0.2 criteria, then a stepwise selection with entry criteria p = 0.05 and stay criteria p = 0.1. Results Of 631 patients included (59.4% male, median age 37 years), 214 (34%) had previous surgery and 152 (24.1%) biologics. Laparoscopy was feasible in 35.9% of cases, 285 patients (45.1%) required surgery on other bowel sites due to multiple locations or fistulae. 281 (44.5%) patients presented with fistulizing disease. Risk factors for 90-day minor complications (22.8%). Risk factors for 90-day major complications (6.8%). Conclusion Risk of minor complications was higher in younger patients, especially after a longer medical treatment. Fistulating disease increases the risks only if the rectum and sigmoid colon are involved. Major complications seem to be related to specific patient’s comorbidities, rather than disease characteristics. Onset of hypertension and neuro-vascular disease, known adverse events of chronic steroid use, should not be underestimated in the preoperative assessment of patients. Poor nutritional status greatly increased the risk of minor and major complications; therefore, any effort should be made towards the nutritional optimisation of Crohn’s patients


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