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Early and late outcomes of a series of 255 patients with Crohn's disease who underwent resection: 10 years of experience at a single referral center.
Sacchetti, Franco; Caprino, Paola; Potenza, Angelo Eugenio; Pastena, Dario; Presacco, Stefano; Sofo, Luigi.
Afiliación
  • Sacchetti F; Abdominal Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
  • Caprino P; Abdominal Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
  • Potenza AE; Abdominal Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
  • Pastena D; Abdominal Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
  • Presacco S; Università Cattolica del Sacro Cuore di Roma, Rome, Italy.
  • Sofo L; Abdominal Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy. luigi.sofo@policlinicogemelli.it.
Updates Surg ; 74(5): 1657-1664, 2022 Oct.
Article en En | MEDLINE | ID: mdl-35841530
Patients with Crohn's disease experience an increased risk of postoperative complications and disease recurrence. The aim of this study was to investigate the role of the risk factors in determining these outcomes and whether preoperative removal of some of these risk factors would optimize the results. We conducted a retrospective study analyzing a consecutive series of 255 patients who underwent surgical resection for Crohn's disease between 2010 and 2020. We considered short- and long-term endpoints, such as postoperative complications categorized according to the Clavien-Dindo classification and the appearance of surgical and endoscopic postoperative recurrence. Univariable and multivariable analyses showed that multiple and extensive localizations increased the incidence of postoperative complications (OR = 2.19; 95% CI 1.05-4.5; p = 0.035 and OR = 1.015; 95% CI 1.003-1.028; p = 0.017 for each cm of resected segment, respectively). Regarding theoretically modifiable factors, preoperative hypoalbuminemia (for each g/L reduction) increased the risk of complications with an OR = 1.1; 95% CI 1.02-1.12; p = 0.003. Preoperative steroid therapy exerted a similar effect, with an OR = 2.6; 95% CI 1.1-5.9; p = 0.018. Modifying these last two risk factors by improving the nutritional status or discontinuing steroid therapy significantly reduced complications.Microscopic positivity of the resection margins was a risk factor for surgical recurrence (OR = 8.7; 95% CI 1.9-40; p = 0.05). Based on the results of the present study, surgeons must examine modifiable risk factors, and careful preoperative tailored management may reduce postoperative complications and disease recurrence.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Crohn Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Updates Surg Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Crohn Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Updates Surg Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia