Su1661 Risk Factors for Postoperative Complications After Ileocecal Resection in Patients With Crohn's Disease

2013 ◽  
Vol 144 (5) ◽  
pp. S-1084
Author(s):  
Michael S. Kasparek ◽  
Sophie Zehl ◽  
Mario Mueller ◽  
Stephan Brand ◽  
Martin E. Kreis
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Ileocecal Resection

scholarly journals Experiences with the Kono-S anastomosis in Crohn’s disease of the terminal ileum—a cohort study

2020 ◽  
Author(s):  
K. Horisberger ◽  
D. L. Birrer ◽  
A. Rickenbacher ◽  
M. Turina
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Ileocecal Resection ◽  
Anastomotic Recurrence ◽  
Short Term ◽  
Recurrence Rates

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.

scholarly journals ANALYSIS OF RISK FACTORS AND POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CROHN’S DISEASE

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
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Perioperative Complications ◽  
Published Data ◽  
Duration Of Surgery ◽  
Low Body Mass Index ◽  
Complications Rate ◽  
Necrosis Factor

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.

scholarly journals DOP62 Morbidity after primary ileocecal resection for Crohn’s disease in the years of biologics: Lesson learned over 631 patients exclusively treated in a tertiary centre

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S101-S102
Author(s):  
M Rottoli ◽  
M Tanzanu ◽  
G Vago ◽  
A Belvedere ◽  
D Parlanti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Medical Treatment ◽  
Univariate Analysis ◽  
Preoperative Assessment ◽  
High Volume ◽  
Ileocecal Resection ◽  
Tertiary Centre ◽  
Major Complications

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

The Influence of Preoperative Medications on Postoperative Complications in Patients After Intestinal Surgery for Crohn’s Disease

2019 ◽  
Vol 25 (9) ◽  
pp. 1559-1568 ◽  
Author(s):  
Chang Sik Yu ◽  
Sung Woo Jung ◽  
Jong Lyul Lee ◽  
Seok-Byung Lim ◽  
In Ja Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Bowel Resection ◽  
Abdominal Sepsis ◽  
Infectious Complications ◽  
Time Of Surgery ◽  
Tnf Α ◽  
Resection And Anastomosis

Abstract Background Many patients with Crohn’s disease (CD) are treated with medications, including steroids, immunomodulators, and anti–tumor necrosis factor alpha (anti-TNF-α) agents, at the time of surgery. This study evaluated the effects of these medications on postoperative complications in CD patients. Methods This retrospective study analyzed patients who underwent bowel resection for CD between January 2006 and December 2015. Postoperative complications were defined as a Clavien-Dindo classification of grade 2A or higher within the first 30 days after surgery. Results Of the 817 patients enrolled, 687 patients received bowel resection and anastomosis without stoma formation. Of 687 patients, 381 (55.5%) were being treated with preoperative medications at the time of surgery (medication group) and 306 (44.5%) were not (nonmedication group). The overall rate of postoperative complications was not different between the medication and nonmedication groups (23.4% vs 21.9%, P = 0.36). Preoperative treatments with immunomodulators plus anti-TNF-α agents (relative risk [RR], 2.314; 95% confidence interval [CI], 1.126–4.753; P = 0.022) and treatment with immunomodulators plus steroids (RR, 2.536; 95% CI, 1.124–5.725; P = 0.025) were risk factors for infectious complications. Preoperative treatments with immunomodulators plus anti-TNF-α agents (RR, 2.731; 95% CI, 1.102–6.769; P = 0.03) and treatment with immunomodulators plus steroids (RR, 3.118; 95% CI, 1.169–8.320; P = 0.023) were significantly associated with increased risk of intra-abdominal sepsis. Conclusions Preoperative treatments with immunomodulators plus anti-TNF-α agents or steroids were risk factors for infectious complications, especially intra-abdominal sepsis in patients who underwent bowel resection and anastomosis.

scholarly journals Risk Factors for Early Postoperative Complications after Surgery for Crohn's Disease

2014 ◽  
Vol 31 (3) ◽  
pp. 147-154 ◽  
Author(s):  
Vladimir Joksimović ◽  
Aleksandar Karagjozov ◽  
Gjorgi Jota ◽  
Ilija Milev ◽  
Radomir Gelevski
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Medical Centre ◽  
Resection Margins ◽  
Digestive Surgery ◽  
Early Postoperative Complications ◽  
Using Data ◽  
The University

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.

Postoperative Complications after Ileocecal Resection in Crohn’s Disease: A Prospective Study From the REMIND Group

2017 ◽  
Vol 112 (2) ◽  
pp. 337-345 ◽  
Author(s):  
Mathurin Fumery ◽  
Philippe Seksik ◽  
Claire Auzolle ◽  
Nicolas Munoz-Bongrand ◽  
Jean-Marc Gornet ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Prospective Study ◽  
Ileocecal Resection ◽  
A Prospective Study

scholarly journals Effects of ω-3 polyunsaturated fatty acid-supplemented parenteral nutrition on postoperative complications for patients with Crohn’s disease: a cohort study

2020 ◽  
Author(s):  
Yan Wu ◽  
Huaying Liu ◽  
Weilin Qi ◽  
Wei Liu ◽  
Shasha Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Parenteral Nutrition ◽  
Eligible Patient ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Post Surgery ◽  
Complication Risk

Abstract Background: Most patients with Crohn's disease (CD), a chronic inflammatory disease, need surgery but exhibit elevated postoperative complication incidences. ω-3 polyunsaturated fatty acids (PUFAs) are considered beneficial for nutrition, anti-inflammation, immunity and intestinal microflora balance in humans. This study assessed the effects of ω-3 PUFA-supplemented parenteral nutrition (PN) on postoperative complications in CD.Methods: Overall, 186 CD patients undergoing bowel resection were eligible. Patient data were collected from a prospectively maintained database. After surgery, 103 patients received ω-3 PUFA-supplemented PN; 83 did not. Postoperative complications were compared between the groups. Complication risk factors were identified by univariate and multivariate analyses.Results: Patients with ω-3 PUFA-supplemented PN after surgery had lower C-reactive protein levels (57.2±5.3 mg/L vs 43.5±3.9 mg/L, P=0.047) and shorter postoperative hospital stays (12.1±1.1 days vs 9.3±0.6 days, P=0.041) than those without. The ω-3 PUFA group exhibited significantly reduced incidences of overall complications (40.8% vs 24.1%, P=0.016) and major complications (23.3% vs 9.6%, P=0.014). Postoperative complications were associated with infliximab, ω-3 PUFAs, C-reactive protein, operative time, and laparoscopic surgery. Multivariate regression revealed that preoperative infliximab use and postoperative ω-3 PUFA-supplemented PN were independent risk factors in CD. Conclusions: ω-3 PUFA-supplemented PN reduced post-surgery inflammatory response in CD patients, thus decreasing postoperative complications and accelerating recovery.Trial registration: This trial was registered in ClinicalTrials.gov. Identifier was NCT03901937. The date of registration was 03/04/2019.

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