Journal of Gastrointestinal Surgery

, Volume 18, Issue 6, pp 1216–1224

The Impact of Peri-operative Anti-TNF Treatment on Anastomosis-Related Complications in Crohn’s Disease Patients. A Critical Review

Authors

  • Ioannis Papaconstantinou
    • Second Department of Surgery, Aretaieion Hospital, Medical SchoolUniversity of Athens
    • Department of GastroenterologyTzaneio General Hospital
  • Maria Gazouli
    • Molecular Carcinogenesis Group, Laboratory of Histology and Embryology, School of MedicineUniversity of Athens
  • Konstantinos Nastos
    • Second Department of Surgery, Aretaieion Hospital, Medical SchoolUniversity of Athens
  • Anneza Yiallourou
    • Second Department of Surgery, Aretaieion Hospital, Medical SchoolUniversity of Athens
  • Apostolos Papalois
    • Experimental-Research Unit, ELPEN-Pharmaceuticals Co. Inc
  • Charalambos Tzathas
    • Department of GastroenterologyTzaneio General Hospital
Review Article

DOI: 10.1007/s11605-014-2487-3

Cite this article as:
Papaconstantinou, I., Zeglinas, C., Gazouli, M. et al. J Gastrointest Surg (2014) 18: 1216. doi:10.1007/s11605-014-2487-3

Abstract

Introduction

Tumor necrosis factor (TNF)α is a cytokine exerting pleiotropic effects on critical cell functions and, most importantly, is the main regulator of pro-inflammatory cytokine production and a key player in the pathophysiology of numerous autoimmune diseases, including Crohn’s disease.

Methods

TNFα became a therapeutic target and TNFα blocking agents are currently used in the treatment of inflammatory diseases. Beyond the therapeutic benefits deriving from TNFα neutralization, amendments in the cellular functions of the immune system may as well induce potent immunosuppressive effects. An attenuated immune response may compromise the intestinal healing ability, thus leading to weaker anastomosis and increased risk of anastomotic leak and septic complications.

Results

This hypothesis raises great concerns about the safety of perioperative administration of anti-TNF and has been the endpoint of numerous studies.

Conclusion

The aim of this review is to critically evaluate the evidence regarding the role of TNFα in anastomosis related complications after abdominal surgery in Crohn’s disease patients.

Keywords

TNFαWound HealingIntestinal anastomosesPostoperative complications

Copyright information

© The Society for Surgery of the Alimentary Tract 2014