The inflammatory bowel diseases (IBDs) are chronic diseases that often require surgery.
However, the risk of requirement of surgery over time has not been well characterized.
Dr Gilaad Kaplan and colleagues from Canada performed a systematic review and meta-analysis to establish the cumulative risk of surgery among patients with IBD, and evaluated how this risk has changed over time.
The team searched Medline, EMBASE, PubMed, and conference proceedings up to 2013, for terms related to IBD and intestinal surgery.
There were 2 reviewers screening 8338 unique citations to identify 486 for full-text review.
|The risk of surgery 10 years after diagnosis of ulcerative colitis was 16%|
The analysis included population-based studies published as articles (n = 26) and abstracts that reported risks of surgery at 1, 5, or 10 years after a diagnosis of Crohn's disease and/or ulcerative colitis.
The trend in risk of surgery over time was analyzed by meta-regression using mixed-effect models.
Based on all population-based studies, the team found that the risk of surgery 1, 5, and 10 years after diagnosis of Crohn's disease was 16%, 33%, and 47%, respectively.
The researchers found that the risk of surgery 1, 5, and 10 years after diagnosis of ulcerative colitis was 5%, 12%, and 16%, respectively.
The risk of surgery 1, 5, and 10 years after diagnosis of Crohn's disease and 1 and 10 years after diagnosis of ulcerative colitis has decreased significantly over the past 6 decades.
Dr Kaplan's team comments, "Based on systematic review and meta-analysis of population-based studies, the risk of intestinal surgery among patients with IBD has decreased over the past 6 decades."