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 21 February 2018

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News

Postoperative complications after ileocecal resection in Crohn’s disease

This month's American Journal of Gastroenterology investigates postoperative complications after ileocecal resection in Crohn’s disease.

News image

Dr Matthieu Allez and colleagues from France determined the frequency of and risk factors for early 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.

Clinical-, biological-, surgical-, and treatment-related data on the 3 months before surgery were collected prospectively.

Patients operated on between 2010 and 2014 were included.

The research team evaluated a total of 209 patients.

The indication for ileocecal resection was stricturing disease in 52% cases, penetrating complications in 42%, and medication-refractory inflammatory disease in 6%.

The researchers reported that a 2-stage procedure was performed in 16% of patients.

There were no postoperative deaths.

33% of of complications were severe
American Journal of Gastroenterology

The research team foun that 21% of patients experienced a total of 54 early postoperative complications after a median time interval of 5 days, intra-abdominal septic complications, extra-intestinal infections, and hemorrhage.

The team observed that 33% of of complications were severe.

The researchers found that reoperation was necessary in 7% of patients, and secondary stomy was performed in 5%.

The researchers observed 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 comments, "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."

Am J Gastroenterol 2017; 112:337–345
24 February 2017

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