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 a...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 stricturingtpenetrating 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.展开更多
Background:Surgery in Crohn’s disease(CD)may be associated with poor prognosis and clinical and surgical recurrence.The aim of this study was to describe and compare the post-operative management and outcomes of pati...Background:Surgery in Crohn’s disease(CD)may be associated with poor prognosis and clinical and surgical recurrence.The aim of this study was to describe and compare the post-operative management and outcomes of patients with CD who underwent first vs recurrent surgeries.Methods:Observational study that included adult CD patients from 26 Spanish hospitals who underwent ileocolonic resection with ileocolonic anastomosis between January 2007 and December 2010.Data were retrospectively collected from the medical records.Results:Data from 314 patients were analysed,of whom 262(83%)underwent first surgery and 52(17%)referred to previous CD surgeries.Baseline characteristics were similar between the two groups except for a higher rate of stricturing behavior at diagnosis among re-operated patients(P=0.03).After surgery,a higher proportion of re-operated patients received prophylactic treatment with immunomodulators compared with patients with first surgery(P=0.04).In re-operated patients,time to clinical recurrence was not associated with the fact of receiving or not prophylaxis,whereas,in patients with first surgery,recurrence-free survival was greater when prophylaxis was received(P=0.03).Conclusions:After surgery,a higher proportion of patients with previous surgeries received prophylactic treatment with immunomodulators compared with patients with first surgery.Although prophylactic treatment was beneficial for preventing clinical recurrence in patients operated on for the first time,it did not significantly reduce the risk of further recurrence in patients with previous surgeries.This suggests that effective prophylactic therapies are still needed in this subset of patients.展开更多
文摘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 stricturingtpenetrating 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.
基金This study was funded by Merck Sharp&Dohme of Spain,a subsidiary of Merck&Co.,Inc.,Kenilworth,New Jersey,USA.
文摘Background:Surgery in Crohn’s disease(CD)may be associated with poor prognosis and clinical and surgical recurrence.The aim of this study was to describe and compare the post-operative management and outcomes of patients with CD who underwent first vs recurrent surgeries.Methods:Observational study that included adult CD patients from 26 Spanish hospitals who underwent ileocolonic resection with ileocolonic anastomosis between January 2007 and December 2010.Data were retrospectively collected from the medical records.Results:Data from 314 patients were analysed,of whom 262(83%)underwent first surgery and 52(17%)referred to previous CD surgeries.Baseline characteristics were similar between the two groups except for a higher rate of stricturing behavior at diagnosis among re-operated patients(P=0.03).After surgery,a higher proportion of re-operated patients received prophylactic treatment with immunomodulators compared with patients with first surgery(P=0.04).In re-operated patients,time to clinical recurrence was not associated with the fact of receiving or not prophylaxis,whereas,in patients with first surgery,recurrence-free survival was greater when prophylaxis was received(P=0.03).Conclusions:After surgery,a higher proportion of patients with previous surgeries received prophylactic treatment with immunomodulators compared with patients with first surgery.Although prophylactic treatment was beneficial for preventing clinical recurrence in patients operated on for the first time,it did not significantly reduce the risk of further recurrence in patients with previous surgeries.This suggests that effective prophylactic therapies are still needed in this subset of patients.
