Abstract

Background

This study is aimed at describing the prevalence of and risk factors associated with early post-operative complications after Crohn’s disease-related intestinal resection.

Methods

This was a retrospective analysis of data from the PRACTICROHN cohort. Adult Crohn’s disease patients who underwent ileocolonic resection with ileocolonic anastomosis between January 2007 and December 2010 were included. The complications evaluated included death, ileus, anastomotic leak, abscess, wound infection, catheter-related infection, digestive bleeding and other extra-abdominal infections that occurred in the 30 days after surgery.

Results

A total of 364 patients (median age at surgery 38 years and 50% men) were included. Indication for surgery was: stricturing disease (46.4%), penetrating disease (31.3%), penetrating and stricturing disease (14.0%) or resistance to medical treatment (5.8%). Early complications were recorded in 100 (27.5%) patients, with wound infection, intra-abdominal abscess and anastomotic leakage being the most frequent complications. Median hospitalization duration was 16 days for patients with complications vs. 9 days without complications (P < 0.001). Complications were more common among patients with penetrating disease (36/114, 31.6%) and those refractory to treatment (9/21, 42.9%) compared with stricturing disease (45/169, 26.6%) or stricturing + penetrating disease (6/51, 11.8%) (P = 0.040). The rate of complications was higher among patients with diagnosis made at the time of surgery (15/31, 48.4%) compared with the rest (85/331, 25.7%) (P = 0.013). Medication received at the time of surgery did not affect the rate of complications.

Conclusions

Almost a quarter of patients developed early complications after intestinal resection. Penetrating disease and urgent surgery were associated with an increased risk of complications.

Details

Title
Perioperative management and early complications after intestinal resection with ileocolonic anastomosis in Crohn’s disease: analysis from the PRACTICROHN study
Author
Gutiérrez, Ana 1 ; Rivero, Montserrat 2 ; Martín-Arranz, Maria Dolores 3 ; Valle García Sánchez 4 ; Castro, Manuel 5 ; Barrio, Jesús 6 ; Ruth de Francisco 7 ; Barreiro-de Acosta, Manuel 8 ; Juliá, Berta 9 ; Cea-Calvo, Luis 9 ; Romero, Cristina 9 ; Sainz, Natalia Borruel 10 ; Domènech, Eugeni 11 

 Gastroenterology Department, General University Hospital of Alicante and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Carlos III Health Institute, Madrid, Spain 
 Gastroenterology Department, Marques de Valdecilla General University Hospital, Santander, Spain 
 Gastroenterology Department, La Paz General University Hospital, Instituto de Investigación Biomédica La Paz (IdiPaz), Madrid, Spain 
 Clinical Management of Gastrointestinal Tract Diseases Unit, Reina Sofia University Hospital, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba University, Cordoba, Spain 
 Gastroenterology Department, Valme University Hospital, Sevilla, Spain 
 Gastroenterology Department, University Hospital, Río Hortega, Valladolid, Spain 
 Gastroenterology Department, University Hospital Central de Asturias, Oviedo, Spain 
 Gastroenterology Department, Inflammatory Bowel Disease Unit, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain 
 Medical Department, Merck Sharp and Dohme, Madrid, Spain 
10  Crohn-Colitis Care Unit (UACC), Digestive Tract Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain 
11  Gastroenterology Department, Germans Trias i Pujol University Hospital and CIBERehd, Badalona, Spain 
Pages
168-175
Publication year
2019
Publication date
Jun 2019
Publisher
Oxford University Press
e-ISSN
20520034
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3169734395
Copyright
© The Author(s) 2019. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-sen University. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.