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Probability, rate and timing of reconstructive surgery following colectomy for inflammatory bowel disease in Sweden: a population-based cohort study
Karolinska University Hospital, Sweden; Karolinska University Hospital, Sweden.
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US. Linköpings universitet, Medicinska fakulteten.
Karolinska Institute, Sweden.
Karolinska Institute, Sweden.
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2015 (Engelska)Ingår i: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 17, nr 10, s. 882-890Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aim Many patients with inflammatory bowel disease (IBD) need colectomy, but the rate of reconstructive surgery with restoration of intestinal continuity is unknown. The aim of this study was to investigate the probability, rate and timing of reconstructive surgery after colectomy in patients with IBD in a population-based setting. Method The study cohort included all patients with IBD in Sweden who underwent colectomy from 2000 to 2009. Each patient was followed from admission for colectomy to admission for reconstructive surgery, date of death, migration or 31 December 2010. Kaplan-Meier survival curves and multivariable Poisson regression models were used to describe the probability, rate and timing of reconstructive surgery. Results Out of 2818 IBD patients treated with colectomy, 61.0% were male and 78.9% had ulcerative colitis. No reconstructive surgery had been performed in 1595 (56.6%) patients by the end of follow-up. Of the remaining 1223 patients, 526 underwent primary reconstructive surgery and 697 had a secondary reconstruction following a median interval of 357 days from primary surgery in the form of colectomy. The probability of reconstructive surgery was dependent on age (55.6% and 18.1% at ages 15-29 and greater than= 59 years, respectively), and the chance of reconstructive surgery was higher in hospitals that performed more than 13 colectomies for IBD per year [incidence rate ratio and 95% confidence interval 1.27 (1.09-1.49)]. Conclusion Fewer than half of the patients having a colectomy for IBD underwent subsequent reconstructive surgery. Older age and low hospital volume were risk factors for no reconstructive surgery.

Ort, förlag, år, upplaga, sidor
WILEY-BLACKWELL , 2015. Vol. 17, nr 10, s. 882-890
Nyckelord [en]
Inflammatory bowel disease; ileorectal anastomosis; ileal pouch-anal anastomosis; colectomy; reconstructive surgery
Nationell ämneskategori
Klinisk medicin
Identifikatorer
URN: urn:nbn:se:liu:diva-121734DOI: 10.1111/codi.12978ISI: 000361213600015PubMedID: 25885419OAI: oai:DiVA.org:liu-121734DiVA, id: diva2:859363
Anmärkning

Funding Agencies|Swedish Society for Medical Research; Stiftelsen Tornspiran; Bengt Ihres Fond

Tillgänglig från: 2015-10-06 Skapad: 2015-10-05 Senast uppdaterad: 2017-12-01

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