PMID- 27372080 OWN - NLM STAT- MEDLINE DCOM- 20170316 LR - 20181113 IS - 1436-2813 (Electronic) IS - 0941-1291 (Linking) VI - 47 IP - 3 DP - 2017 Mar TI - Short-term outcomes of laparoscopic surgery for Crohn's disease patients treated with anti-tumor necrosis factor alpha agents. PG - 320-327 LID - 10.1007/s00595-016-1375-8 [doi] AB - PURPOSE: The impact of anti-tumor necrosis factor alpha (TNFalpha) treatment for Crohn's disease (CD) on surgical outcomes is still controversial. The aim of this study was to assess the feasibility of laparoscopic surgery for CD patients treated preoperatively with anti-TNFalpha agents. METHODS: We investigated, retrospectively, the clinical features and surgical outcomes of 35 consecutive CD patients who underwent laparoscopic surgery after receiving scheduled anti-TNFalpha treatment preoperatively. We compared the surgical outcomes of an "early surgery group", comprised of patients who underwent surgery less than 3 years after the initiation of anti-TNFalpha treatment, with those of a "late surgery group", comprised of patients who underwent surgery more than 3 years after the initiation of anti-TNFalpha treatment. RESULTS: The mean operating time and blood loss were 203 min and 259 mL, respectively. The rates of conversion to open surgery and postoperative complications were 8.6 and 11.4 %, respectively. Operating time and blood loss were correlated with the interval between the initiation of anti-TNFalpha agent treatment and the time of surgery. The proportion of patients with acquired resistance to anti-TNFalpha agents and the rate of conversion to open surgery were higher and operating times were longer in the late surgery group than in the early surgery group. CONCLUSION: Laparoscopic surgery can be performed safely for CD patients treated preoperatively with anti-TNFalpha agents, although operating times may be longer and estimated blood loss (EBL) greater for those who have been on prolonged anti-TNFalpha treatment. FAU - Hata, Tsuyoshi AU - Hata T AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. FAU - Mizushima, Tsunekazu AU - Mizushima T AUID- ORCID: 0000-0002-0825-6823 AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. tmizushima@gesurg.med.osaka-u.ac.jp. AD - Department of Therapeutics for Inflammatory Bowel Diseases, Graduate School of Medicine, Osaka University, Osaka, Japan. tmizushima@gesurg.med.osaka-u.ac.jp. FAU - Osawa, Hideki AU - Osawa H AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. FAU - Takahashi, Hidekazu AU - Takahashi H AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. FAU - Haraguchi, Naotsugu AU - Haraguchi N AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. FAU - Nishimura, Junichi AU - Nishimura J AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. FAU - Hata, Taishi AU - Hata T AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. FAU - Takemasa, Ichiro AU - Takemasa I AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. AD - Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan. FAU - Ikenaga, Masakazu AU - Ikenaga M AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. AD - Department of Surgery, Higashiosaka City General Hospital, Osaka, Japan. FAU - Nakajima, Kiyokazu AU - Nakajima K AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. FAU - Yamamoto, Hirofumi AU - Yamamoto H AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. FAU - Murata, Kohei AU - Murata K AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. AD - Department of Surgery, Suita Municipal Hospital, Osaka, Japan. FAU - Doki, Yuichiro AU - Doki Y AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. FAU - Mori, Masaki AU - Mori M AD - Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. LA - eng PT - Journal Article DEP - 20160702 PL - Japan TA - Surg Today JT - Surgery today JID - 9204360 RN - 0 (Tumor Necrosis Factor-alpha) RN - B72HH48FLU (Infliximab) RN - FYS6T7F842 (Adalimumab) SB - IM MH - Adalimumab/*administration & dosage MH - Adult MH - Blood Loss, Surgical/statistics & numerical data MH - Combined Modality Therapy MH - Crohn Disease/*surgery MH - Digestive System Surgical Procedures/*methods MH - Feasibility Studies MH - Female MH - Humans MH - Infliximab/*administration & dosage MH - Laparoscopy/*methods MH - Male MH - Middle Aged MH - Operative Time MH - Postoperative Complications/epidemiology MH - Preoperative Care MH - Retrospective Studies MH - Time Factors MH - Treatment Outcome MH - Tumor Necrosis Factor-alpha/*antagonists & inhibitors OTO - NOTNLM OT - Adalimumab OT - Crohn's disease OT - Infliximab OT - Laparoscopic surgery OT - TNFalpha EDAT- 2016/07/04 06:00 MHDA- 2017/03/17 06:00 CRDT- 2016/07/04 06:00 PHST- 2016/03/01 00:00 [received] PHST- 2016/06/10 00:00 [accepted] PHST- 2016/07/04 06:00 [pubmed] PHST- 2017/03/17 06:00 [medline] PHST- 2016/07/04 06:00 [entrez] AID - 10.1007/s00595-016-1375-8 [pii] AID - 10.1007/s00595-016-1375-8 [doi] PST - ppublish SO - Surg Today. 2017 Mar;47(3):320-327. doi: 10.1007/s00595-016-1375-8. Epub 2016 Jul 2.