Academic Journal
Postoperative complications after ileocecal resection in Crohn's disease: A prospective study from the REMIND group
| العنوان: | Postoperative complications after ileocecal resection in Crohn's disease: A prospective study from the REMIND group |
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| المؤلفون: | Fumery, Mathurin, Seksik, Philippe, Auzolle, Claire, Munoz-Bongrand, Nicolas, Gornet, Jean-Marc, Boschetti, Gilles, Cotte, Eddy, Buisson, Anthony, Dubois, Anne, Pariente, Benjamin, Zerbib, Philippe, Chafai, Najim, Stefanescu, Carmen, Panis, Yves, Marteau, Philippe, Pautrat, Karine, Sabbagh, Charles, Filippi, Jerome, Chevrier, Marc, Houze, Pascal, Jouven, Xavier, Treton, Xavier, Allez, Matthieu |
| المساهمون: | Département de Gastroentérologie, Hôpital Européen Fondation Ambroise Paré - Marseille, Laboratoire d'Analyses Médicales, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), INSERM, U1160, Département de Gastroentérologie, Université Paris Diderot - Paris 7 (UPD7), Department of Gastroenterological Surgery, Hop St Louis, Hospices Civils de Lyon (HCL), Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne 2017-2020 (UCA 2017-2020 )-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne), CHU Estaing Clermont-Ferrand, CHU Clermont-Ferrand-CHU Clermont-Ferrand, Départment de Gastroentérologie, Université de Lille, Droit et Santé, CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department Colorectal Surgery, Department of Gastroenterological Surgery and Transplantation, Université Lille Nord de France (COMUE), Hôpital Lariboisière-Fernand-Widal APHP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Department Digestion and Oncology Surgery, Université de Picardie Jules Verne (UPJV), Département de Gastroentérogie et Clinique Nutrition, Université de Nice Sophia-Antipolis (UNSA), CHU Trousseau APHP, Department Gastroenteroly IBD and Nutrition Support, Association Francois Aupetit, MSD France, Helmsley Charitable Trust |
| المصدر: | ISSN: 0002-9270. |
| بيانات النشر: | HAL CCSD Lippincott, Williams & Wilkins |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | risk factor, inflammatory disease, crohn disease, intestine, intestin, chirurgie, maladie de crohn, maladie inflammatoire, facteur de risque, thérapie, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology |
| الوصف: | OBJECTIVES: We sought to determine the frequency of and risk factors for early (30-day) postoperative complications after ileocecal resection in a well-characterized, prospective cohort of Crohn's disease patients. METHODS: The REMIND group performed a nationwide study in 9 French university medical centers. Clinical-, biological-, surgical-, and treatment-related data on the 3 months before surgery were collected prospectively. Patients operated on between 1 September 2010 and 30 August 2014 were included. RESULTS: A total of 209 patients were included. The indication for ileocecal resection was stricturing disease in 109 (52%) cases, penetrating complications in 88 (42%), and medication-refractory inflammatory disease in 12 (6%). A two-stage procedure was performed in 33 (16%) patients. There were no postoperative deaths. Forty-three (21%) patients (23% of the patients with a one-stage procedure vs. 9% of those with a two-stage procedure, P=0.28) experienced a total of 54 early postoperative complications after a median time interval of 5 days (interquartile range, 4-12): intra-abdominal septic complications (n=38), extraintestinal infections (n=10), and hemorrhage (n=6). Eighteen complications (33%) were severe (Dindo-Clavien III-IV). Reoperation was necessary in 14 (7%) patients, and secondary stomy was performed in 8 (4.5%). In a multivariate analysis, corticosteroid treatment in the 4 weeks before surgery was significantly associated with an elevated postoperative complication rate (odds ratio (95% confidence interval)=2.69 (1.15-6.29); P=0.022). Neither preoperative exposure to anti-tumor necrosis factor (TNF) agents (n=93, 44%) nor trough serum anti-TNF levels were significant risk factors for postoperative complications. CONCLUSIONS: In this large, nationwide, prospective cohort, postoperative complications were observed after 21% of the ileocecal resections. Corticosteroid treatment in the 4 weeks before surgery was significantly associated with an elevated postoperative complication rate. In contrast, ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/27958285; hal-01604351; https://hal.science/hal-01604351; PRODINRA: 394978; PUBMED: 27958285; WOS: 000394133600022 |
| DOI: | 10.1038/ajg.2016.541 |
| الاتاحة: | https://hal.science/hal-01604351 https://doi.org/10.1038/ajg.2016.541 |
| رقم الانضمام: | edsbas.CF6001A4 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1038/ajg.2016.541 |
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