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Complications in surgery for Crohns disease after preoperative antitumour necrosis factor therapy
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Oxford University Hospital, England .
Oxford University Hospital, England University Hospital Valle de Hebron, Spain .
Oxford University Hospital, England .
University of Oslo, Norway Akershus University Hospital, Norway .
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2014 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 101, no 5, 539-545 p.Article in journal (Refereed) Published
Abstract [en]

Background: The use of biological therapy (biologicals) is established in the treatment of Crohns disease. This study aimed to determine whether preoperative treatment with biologicals is associated with an increased rate of complications following surgery for Crohns disease with intestinal anastomosis. Methods: All patients receiving biologicals and undergoing abdominal surgery with anastomosis or strictureplasty were identified at six tertiary referral centres. Demographic data, and preoperative, operative and postoperative details were registered. Patients who were treated with biologicals within 2 months before surgery were compared with a control group who were not. Postoperative complications were classified according to anastomotic, infectious or other complications, and graded according to the Clavien-Dindo classification. Results: Some 111 patients treated with biologicals within 2 months before surgery were compared with 187 patients in the control group. The groups were well matched. There were no differences between the treatment and control groups in the rate of complications of any type (34.2 versus 28.9 per cent respectively; P = 0.402), anastomotic complications (7.2 versus 8.0 per cent; P = 0.976) and non-anastomotic infectious complications (16.2 versus 13.9 per cent; P = 0.586). In univariable regression analysis, biologicals were not associated with an increased risk of any complication (odds ratio (OR) 1.33, 95 per cent confidence interval 0.81 to 2.20), anastomotic complication (OR 0.89, 0.37 to 2.17) or infectious complication (OR 1.09, 0.62 to 1.91). Conclusion: Treatment with biologicals within 2 months of surgery for Crohns disease with intestinal anastomosis was not associated with an increased risk of complications.

Place, publisher, year, edition, pages
Wiley , 2014. Vol. 101, no 5, 539-545 p.
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-106513DOI: 10.1002/bjs.9439ISI: 000332700100015OAI: oai:DiVA.org:liu-106513DiVA: diva2:716649
Available from: 2014-05-12 Created: 2014-05-09 Last updated: 2017-12-05

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Myrelid, Pär

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Division of Clinical SciencesFaculty of Health SciencesDepartment of Surgery in Linköping
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