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Short-term outcomes of laparoscopic surgery for Crohn’s disease patients treated with anti-tumor necrosis factor alpha agents

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Abstract

Purpose

The impact of anti-tumor necrosis factor alpha (TNFα) treatment for Crohn’s disease (CD) on surgical outcomes is still controversial. The aim of this study was to assess the feasibility of laparoscopic surgery for CD patients treated preoperatively with anti-TNFα agents.

Methods

We investigated, retrospectively, the clinical features and surgical outcomes of 35 consecutive CD patients who underwent laparoscopic surgery after receiving scheduled anti-TNFα treatment preoperatively. We compared the surgical outcomes of an “early surgery group”, comprised of patients who underwent surgery less than 3 years after the initiation of anti-TNFα treatment, with those of a “late surgery group”, comprised of patients who underwent surgery more than 3 years after the initiation of anti-TNFα treatment.

Results

The mean operating time and blood loss were 203 min and 259 mL, respectively. The rates of conversion to open surgery and postoperative complications were 8.6 and 11.4 %, respectively. Operating time and blood loss were correlated with the interval between the initiation of anti-TNFα agent treatment and the time of surgery. The proportion of patients with acquired resistance to anti-TNFα agents and the rate of conversion to open surgery were higher and operating times were longer in the late surgery group than in the early surgery group.

Conclusion

Laparoscopic surgery can be performed safely for CD patients treated preoperatively with anti-TNFα agents, although operating times may be longer and estimated blood loss (EBL) greater for those who have been on prolonged anti-TNFα treatment.

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Authors and Affiliations

  1. Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Tsuyoshi Hata, Tsunekazu Mizushima, Hideki Osawa, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Taishi Hata, Ichiro Takemasa, Masakazu Ikenaga, Kiyokazu Nakajima, Hirofumi Yamamoto, Kohei Murata, Yuichiro Doki & Masaki Mori

  2. Department of Therapeutics for Inflammatory Bowel Diseases, Graduate School of Medicine, Osaka University, Osaka, Japan

    Tsunekazu Mizushima

  3. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan

    Ichiro Takemasa

  4. Department of Surgery, Higashiosaka City General Hospital, Osaka, Japan

    Masakazu Ikenaga

  5. Department of Surgery, Suita Municipal Hospital, Osaka, Japan

    Kohei Murata

Authors
  1. Tsuyoshi Hata
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  2. Tsunekazu Mizushima
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  3. Hideki Osawa
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  4. Hidekazu Takahashi
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  7. Taishi Hata
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  12. Kohei Murata
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  13. Yuichiro Doki
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  14. Masaki Mori
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Corresponding author

Correspondence to Tsunekazu Mizushima.

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Conflict of interest

None of the authors has any conflicts of interest or financial ties to disclose: T Hata, T Mizushima, H Osawa, H Takahashi, N Haraguchi, J Nishimura, T Hata, I Takemasa, M Ikenaga, K Nakajima, H Yamamoto, K Murata, Y Doki, M Mori.

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Hata, T., Mizushima, T., Osawa, H. et al. Short-term outcomes of laparoscopic surgery for Crohn’s disease patients treated with anti-tumor necrosis factor alpha agents. Surg Today 47, 320–327 (2017). https://doi.org/10.1007/s00595-016-1375-8

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  • DOI: https://doi.org/10.1007/s00595-016-1375-8

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