Dr Matthieu Allez and colleagues from France sought to determine the frequency of, and risk factors for early (30-day) postoperative complications after ileocecal resection in a well-characterized, prospective cohort of Crohn’s disease patients.
The REMIND group performed a nationwide study in 9 French university medical centers.
The team collected prospectively clinical-, biological-, surgical-, and treatment-related data on the 3 months before surgery.
Patients operated on between 2010 and 2014 were included.
The research team included a total of 209 patients.
The team noted that the indication for ileocecal resection was stricturing disease in 52% cases, penetrating complications 42%, and medication-refractory inflammatory disease in 6%.
The researchers performed a 2-stage procedure in 16% of patients.
There were no postoperative deaths.
The team found that 21% of patients experienced a total of 54 early postoperative complications after a median time interval of 5 days, extra-intestinal infections, and hemorrhage.
The research team noted that 33% were severe.
Reoperation was necessary in 7% of patients, and secondary stomy was performed in 5%.
On further analysis, the researchers found that corticosteroid treatment in the 4 weeks before surgery was significantly associated with an elevated postoperative complication rate.
Neither preoperative exposure to anti-tumor necrosis factor (TNF) agents nor trough serum anti-TNF levels were significant risk factors for postoperative complications.
Dr Allez's team concludes, "In this large, nationwide, prospective cohort, postoperative complications were observed after 21% of the ileocecal resections."
"Corticosteroid treatment in the 4 weeks before surgery was significantly associated with an elevated postoperative complication rate."
"In contrast, preoperative anti-TNF therapy was not associated with an elevated risk of postoperative complications."