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Biological therapy prior to repeat ileocolic resection in Crohn’s disease can reduce the postoperative complication rate

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Abstract

Background

The aim of this study was to assess the effect of preoperative biologic therapy on the surgical outcome of Crohn’s disease (CD) patients undergoing repeat ileocolic resection.

Methods

This was a retrospective analysis of all CD patients who underwent repeat ileocolic resection at Cleveland Clinic Florida between January 2011 and April 2021. Patients were divided into two groups: treatment biologic therapy prior to surgery and controls.

Results

Sixty-five patients (31males, median age 54 [range 23–82] years) were included in the study. Twenty nine (44.6%) were treated with biologic therapy prior to repeat ileocolic resection. No demographic differences were found between the biologic therapy and control groups. In addition, no differences were found in mean time from index ileocolic resection (p = 0.9), indication for surgery (p = 0.11), and preoperative albumin (p = 0.69). The majority of patients (57; 87.7%) were operated on laparoscopically, and mean overall operation time was 225 (SD 49.27) min. Overall, the postoperative complication rate was 43.1% (28 patients) and median length of stay was 5 (range 2–21) days. Postoperative complications were more common in the control group, compared to the biologic therapy group (55.6 vs 27.5%; p = 0.04). Conversion rate (35.7 vs 20.7%; p = 0.24), operation time (223 vs 219 min; p = 0.75), length of stay (5.2 vs 5.9 days; p = 0.4), and readmission (16.6 vs 11.1%; p = 0.72) were similar between the two groups. Multivariate analysis of risk factors for postoperative complications showed that biologic treatment was correlated with a lower risk (HR −0.28, CI 95% −0.5596 to −0.01898, p = 0.03).

Conclusions

Patients treated with biologic therapy for CD who underwent repeat ileocolic resection had fewer postoperative complications.

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Funding

This study has received no funding or financial support.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA

    N. Horesh, M. R. Freund, Z. Garoufalia, R. Gefen, D. Zhang, T. Smith, S. H. Emile & S. D. Wexner

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  1. N. Horesh
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  2. M. R. Freund
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  3. Z. Garoufalia
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  4. R. Gefen
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  5. D. Zhang
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  6. T. Smith
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  7. S. H. Emile
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  8. S. D. Wexner
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Correspondence to S. D. Wexner.

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Presentation

Poster at the American Gastroentrological Association - “Crohn's & Colitis Congress”, Las Vegas, Nevada—January 20–22, 2022.

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Horesh, N., Freund, M.R., Garoufalia, Z. et al. Biological therapy prior to repeat ileocolic resection in Crohn’s disease can reduce the postoperative complication rate. Tech Coloproctol 27, 291–296 (2023). https://doi.org/10.1007/s10151-022-02702-0

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  • DOI: https://doi.org/10.1007/s10151-022-02702-0

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