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Association between preoperative biologic use and surgical morbidity in patients with Crohn’s disease

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

We evaluated the influence of preoperative treatments with biologics on surgical morbidity in patients with Crohn’s disease (CD).

Methods

We reviewed the surveillance data of patients with CD who underwent surgery between April 2018 and April 2021. The possible risk factors for morbidity were analyzed.

Results

A total of 305 surgically treated patients were included. Anti-TNF alpha agents and ustekinumab were used in 92 and 27 patients, respectively, within 12 weeks before surgery. There were no cases of mortality. In total, 70/305 (23.0%) patients developed a complication, and 42/305 (13.8%) patients developed a surgical site infection (SSI) (17 incisional SSIs and 35 organ/space SSIs). Current smoking status (OR 3.44), emergent/urgent surgery (OR 6.85), and abdominoperineal resection (APR) (OR 14.93) were identified as risk factors for total complications. Penetrating disease (OR 14.55) was identified as a risk factor for incisional SSIs. Current smoking status (OR 7.09), an American Society of Anesthesiologists (ASA) score greater than 3 (OR 5.85), a postoperative blood sugar level over 155 mg/dL (OR 4.37), and APR (OR 207.95) were identified as risk factors for organ/space SSIs.

Conclusions

No correlation between preoperative treatment with biologics and surgical mortality or morbidity was found. However, we should perform further analyses on a larger number of patients because the analyses may be limited by selection bias for treatment and several confounding factors.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Hyogo Medical University, 1-1, Mukogawacho, Nishinomiya, Hyogo, Japan

    Motoi Uchino, Hiroki Ikeuchi, Yuki Horio, Ryuichi Kuwahara, Tomohiro Minagawa, Kurando Kusunoki, Yoshiko Goto, Naohito Beppu & Masataka Ikeda

  2. Division of Infection Control and Prevention, 1-1, Mukogawacho, Nishinomiya, Hyogo, Japan

    Kaoru Ichiki, Takashi Ueda & Kazuhiko Nakajima

Authors
  1. Motoi Uchino
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  2. Hiroki Ikeuchi
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  3. Yuki Horio
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  4. Ryuichi Kuwahara
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  5. Tomohiro Minagawa
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  6. Kurando Kusunoki
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  7. Yoshiko Goto
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  8. Naohito Beppu
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  9. Kaoru Ichiki
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  10. Takashi Ueda
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  11. Kazuhiko Nakajima
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  12. Masataka Ikeda
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Contributions

Motoi Uchino, conception and design of the study, data analysis, and drafting of the article; Yuki Horio, Ryuichi Kuwahara, Tomohiro Minagawa, Kusunoki Kurando, Yoshiko Goto, Naohito Beppu, and Masataka Ikeda, data acquisition; Kazuhiko Nakajima, Kaoru Ichiki, and Takashi Ueda, SSI data acquisition (infection control team); Hiroki Ikeuchi and Masataka Ikeda, interpretation of the data and critical revision of the article.

Corresponding author

Correspondence to Motoi Uchino.

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The authors declare no competing interests.

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Uchino, M., Ikeuchi, H., Horio, Y. et al. Association between preoperative biologic use and surgical morbidity in patients with Crohn’s disease. Int J Colorectal Dis 37, 999–1010 (2022). https://doi.org/10.1007/s00384-022-04140-8

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  • DOI: https://doi.org/10.1007/s00384-022-04140-8

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