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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.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
Karolinska Institute, Sweden.
Karolinska Institute, Sweden.
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2015 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 17, no 10, 882-890 p.Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
WILEY-BLACKWELL , 2015. Vol. 17, no 10, 882-890 p.
Keyword [en]
Inflammatory bowel disease; ileorectal anastomosis; ileal pouch-anal anastomosis; colectomy; reconstructive surgery
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-121734DOI: 10.1111/codi.12978ISI: 000361213600015PubMedID: 25885419OAI: oai:DiVA.org:liu-121734DiVA: diva2:859363
Note

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

Available from: 2015-10-06 Created: 2015-10-05 Last updated: 2015-10-06

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Myrelid, Pär
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Division of Clinical SciencesDepartment of Surgery in LinköpingFaculty of Medicine and Health Sciences
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