Journal of Gastrointestinal Surgery

, Volume 18, Issue 6, pp 1216–1224 | Cite as

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

  • Ioannis Papaconstantinou
  • Christos Zeglinas
  • Maria Gazouli
  • Konstantinos Nastos
  • Anneza Yiallourou
  • Apostolos Papalois
  • Charalambos Tzathas
Review Article



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.


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.


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


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.


TNFα Wound Healing Intestinal anastomoses Postoperative complications 


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Copyright information

© The Society for Surgery of the Alimentary Tract 2014

Authors and Affiliations

  • Ioannis Papaconstantinou
    • 1
  • Christos Zeglinas
    • 2
  • Maria Gazouli
    • 3
  • Konstantinos Nastos
    • 1
  • Anneza Yiallourou
    • 1
  • Apostolos Papalois
    • 4
  • Charalambos Tzathas
    • 2
  1. 1.Second Department of Surgery, Aretaieion Hospital, Medical SchoolUniversity of AthensAthensGreece
  2. 2.Department of GastroenterologyTzaneio General HospitalPiraeusGreece
  3. 3.Molecular Carcinogenesis Group, Laboratory of Histology and Embryology, School of MedicineUniversity of AthensAthensGreece
  4. 4.Experimental-Research Unit, ELPEN-Pharmaceuticals Co. IncPikermi AttikisGreece

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