Abstract

Background

There is widespread concern that treatment with biologic agents may be associated with suboptimal postoperative outcome after surgery for inflammatory bowel diseases (IBD).

Aim

We aimed to search and analyze the literature regarding the potential association of biologic treatment on adverse postoperative outcome in patients with IBD. We used the subject as a case in point for surgical research. The aim was not to conduct a new systematic review.

Method

This is an updated narrative review written in a collaborative method by authors invited through Twitter via the following hashtags (#OpenSourceResearch and #SoMe4Surgery). The manuscript was presented as slides on Twitter to allow discussion of each section of the paper sequentially. A Google document was created, which was shared across social media, and comments and edits were verified by the primary author to ensure accuracy and consistency.

Results

Forty-one collaborators responded to the invitation, and a total of 106 studies were identified that investigated the potential association of preoperative biological treatment on postoperative outcome in patients with IBD. Most of these studies were retrospective observational cohorts: 3 were prospective, 4 experimental, and 3 population-based studies. These studies were previously analyzed in 10 systematic/narrative reviews and 14 meta-analyses. Type of biologic agents, dose, drug concentration, antidrug antibodies, interval between last dose, and types of surgery varied widely among the studies. Adjustment for confounders and bias control ranged from good to very poor. Only 10 studies reported postoperative outcome according to Clavien–Dindo classification.

Conclusion

Although a large number of studies investigated the potential effect of biological treatment on postoperative outcomes, many reported divergent results. There is a need for randomized controlled trials. Future studies should focus on the avoiding the weakness of prior studies we identified. Seeking collaborators and sharing information via Twitter was integral to widening the contributors/authors and peer review for this article and was an effective method of collaboration.

Details

Title
Biological Treatment and the Potential Risk of Adverse Postoperative Outcome in Patients With Inflammatory Bowel Disease: An Open-Source Expert Panel Review of the Current Literature and Future Perspectives
Author
El-Hussuna, Alaa 1 ; Myrelid, Pär 2 ; Holubar, Stefan D 3 ; Kotze, Paulo G 4 ; Mackenzie, Graham 5 ; Pellino, Gianluca 6 ; Winter, Des 7 ; Davies, Justin 8 ; Negoi, Ionut 9 ; Grewal, Perbinder 10 ; Gallo, Gaetano 11 ; Sahnan, Kapil 12 ; Rubio-Perez, Ines 13 ; Clerc, Daniel 14 ; Demartines, Nicolas 15 ; Glasbey, James 16 ; Regueiro, Miguel 17 ; Sherif, Ahmed E 18 ; Neary, Peter 19 ; Pata, Francesco 20 ; Silverberg, Mark 21 ; Clermont, Stefan 22 ; Chadi, Sami A 23 ; Sameh Emile 24 ; Buchs, Nicolas 25 ; Millan, Monica 26 ; Minaya-Bravo, Ana 27 ; Elfeki, Hossam 28 ; De Simone, Veronica 29 ; Shalaby, Mostafa 28 ; Gutierrez, Celestino 30 ; Ozen, Cihan 1 ; Yalçınkaya, Ali 31 ; Rivadeneira, David 32 ; Sturiale, Alssandro 33 ; Yassin, Nuha 34 ; Spinelli, Antonino 35 ; Warusavitarne, Jay 36 ; Ioannidis, Argyrios 37 ; Wexner, Steven 38 ; Mayol, Julio 39 

1  Department of Surgery, Aalborg University Hospital, Aalborg, Denmark 
2  Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden 
3  Director of Research, Department of Colon & Rectal Surgery, Cleveland, OH 
4  Colorectal Surgery Unit, Catholic University of Parana (PUCPR), Curitiba, Brazil 
5  Public Health, NHS Lothian, Edinburgh, UK 
6  Department of Surgery, Università della Campania Luigi Vanvitelli, Aversa, Italy 
7  Centre for Colorectal Disease, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland 
8  Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, UK 
9  Carol Davila University of Medicine and Pharmacy Bucharest, Romania 
10  Department of Cardiovascular, University Hospital Southampton, UK 
11  Department of General Surgery, “Magna Graecia” University, Catanzaro, Italy 
12  Imperial College Faculty of Medicine, Department of Surgery and St Marks Hospital, London, UK 
13  General and Digestive Surgery Department, La Paz University Hospital, Madrid, Spain 
14  Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland 
15  Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland 
16  Academic Department of Surgery, University of Birmingham Heritage Building, UK 
17  Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic, Cleveland, OH 
18  Department of Clinical Surgery, University of Edinburgh, UK 
19  South East Cancer Governance Lead, University Hospital Waterford/Cork, Ireland 
20  Department of Surgery, Sant’Antonio Abate Hospital, Gallarate, Italy 
21  Mount Sinai Hospital Inflammatory Bowel Disease Centre, University of Toronto, ON, Canada 
22  Zuyderland medical center, Heerlen, the Netherlands 
23  Division of General Surgery, University Health Network, Toronto, Ontario, Canada 
24  General Surgery Department, Mansoura Faculty of Medicine, Mansoura City, Egypt 
25  Department of Surgery, University Hospitals of Geneva, Switzerland 
26  Department of Surgery, Joan XXIII University Hospital, Tarragona, Spain 
27  University Henares Hospital, Coslada, Madrid, Spain 
28  Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Egypt 
29  Proctology Unit, Catholic University, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy 
30  Department of Suregry, Centre Hospitalier de Redon Ille-et-Vilaine Bretagne-France 
31  Gazi University, Faculty of Medicine, Ankara, Turkey 
32  Colorectal Surgery & Surgical Services, Northwell Health in Huntington, NY, USA 
33  Proctological and Perineal Surgical Unit, Cisanello University Hospital, Pisa, Italy 
34  Department of surgery, Royal Wolverhampton Hoaspital, UK 
35  Humanitas Clinical and Research Center, Humanitas University, Milan, Italy 
36  Imperial College London, London, UK 
37  Department of General, Laparoscopic and Robotic Surgery, Athens Medical Center 
38  Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL 
39  Hospital Clínico San C 
Publication year
2019
Publication date
Oct 2019
Publisher
Oxford University Press
e-ISSN
2631827X
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1093/crocol/otz021
ProQuest document ID
3169703936
Copyright
© 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. 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.