Fast-track management is safe and effective after bowel resection in children with Crohn's disease

Abstract Aim Bowel resection in Crohn's disease still has a high rate of complications due to risk factors including immune suppression, malnutrition and active inflammation or infection at the time of operating. In this study, we use serological levels and inflammatory markers to predict the potential of complications in patients undergoing resections for complicated Crohn's disease. Methods All patients undergoing laparoscopic bowel resection for Crohn’s disease from 5th of November 2012 to 11th of October 2017 were included in this retrospective observational study. Patients were divided into 4 groups scoring 0, 1, 2 or 3 depending on their pre-operative haemoglobin concentration (Hb), C-reactive protein (CRP) and albumin (Alb) where 1 point was given for an abnormal value in each as detailed in the definitions. They were then grouped into a low risk group comprised of those scoring 0 and 1, and a high risk group for those scoring 2 and 3 and data was collected to compare outcomes and the incidence of septic complications. Results Seventy-nine patients were included. Eleven (13.9%) and 2 (2.5%) patients had 2 or 3 abnormal values of CRP, Alb and Hb and were categorized as high risk. High risk patients had a significantly higher rate of post-operative septic complications (30.7%) compared with low risk patients (10.6%) p value < 0.0001. Conclusion Pre-operative CRP, haemoglobin and albumin can serve as predictors of septic complications after surgery for Crohn’s disease and can therefore be used to guide pre-operative optimisation and clinical decision-making.

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Variation of faecal calprotectin level within the first three months after bowel resection is predictive of endoscopic postoperative recurrence in Crohn's disease

Digestive and Liver Disease ◽

10.1016/j.dld.2020.03.020 ◽

2020 ◽

Vol 52 (7) ◽

pp. 740-744

Author(s):

Mathilde Boube ◽

David Laharie ◽

Stéphane Nancey ◽

Xavier Hebuterne ◽

Mathurin Fumery ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Resection ◽

Postoperative Recurrence ◽

Faecal Calprotectin ◽

Calprotectin Level

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A preoperative low nutritional prognostic index correlates with the incidence of incisional surgical site infections after bowel resection in patients with Crohn’s disease

Surgery Today ◽

10.1007/s00595-014-1044-8 ◽

2014 ◽

Vol 45 (11) ◽

pp. 1366-1372 ◽

Cited By ~ 17

Author(s):

Kiyoshi Maeda ◽

Hisashi Nagahara ◽

Masatsune Shibutani ◽

Hiroshi Otani ◽

Katsunobu Sakurai ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Resection ◽

Prognostic Index ◽

Surgical Site Infections

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Outcomes of Bowel Resection in Patients with Crohn's Disease

The American Surgeon ◽

10.1177/000313481508101022 ◽

2015 ◽

Vol 81 (10) ◽

pp. 1021-1027 ◽

Cited By ~ 4

Author(s):

Zhobin Moghadamyeghaneh ◽

Joseph C. Carmichael ◽

Steven D. Mills ◽

Alessio Pigazzi ◽

Michael J. Stamos

Keyword(s):

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Mortality Risk ◽

Bowel Disease ◽

Large Bowel ◽

Bowel Resection ◽

Multivariate Regression Analysis ◽

Colonic Disease ◽

Small Bowel Disease

There is limited data regarding outcomes of bowel resection in patients with Crohn's disease. We sought to investigate complications of such patients after bowel resection. The Nationwide Inpatient Sample databases were used to examine the clinical data of Crohn's patients who underwent bowel resection during 2002 to 2012. Multivariate regression analysis was performed to investigate outcomes of such patients. We sampled a total of 443,950 patients admitted with the diagnosis of Crohn's disease. Of these, 20.5 per cent had bowel resection. Among patients who had bowel resection, 51 per cent had small bowel Crohn's disease, 19.4 per cent had large bowel Crohn's disease, and 29.6 per cent had both large and small bowel Crohn's disease. Patients with large bowel disease had higher mortality risk compared with small bowel disease [1.8% vs 1%, adjusted odds ratio (AOR): 2.42, P < 0.01]. Risks of postoperative renal failure (AOR: 1.56, P < 0.01) and respiratory failure (AOR: 1.77, P < 0.01) were higher in colonic disease compared with small bowel disease but postoperative enteric fistula was significantly higher in patients with small bowel Crohn's disease (AOR: 1.90, P < 0.01). Of the patients admitted with the diagnosis of Crohn's disease, 20.5 per cent underwent bowel resection during 2002 to 2012. Although colonic disease has a higher mortality risk, small bowel disease has a higher risk of postoperative fistula.

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