PMID- 30753560
OWN - NLM
STAT- MEDLINE
DCOM- 20200501
LR  - 20200501
IS  - 1536-4844 (Electronic)
IS  - 1078-0998 (Linking)
VI  - 25
IP  - 9
DP  - 2019 Aug 20
TI  - The Influence of Preoperative Medications on Postoperative Complications in 
      Patients After Intestinal Surgery for Crohn's Disease.
PG  - 1559-1568
LID - 10.1093/ibd/izz010 [doi]
AB  - BACKGROUND: Many patients with Crohn's disease (CD) are treated with medications, 
      including steroids, immunomodulators, and anti-tumor necrosis factor alpha 
      (anti-TNF-alpha) agents, at the time of surgery. This study evaluated the effects of 
      these medications on postoperative complications in CD patients. METHODS: This 
      retrospective study analyzed patients who underwent bowel resection for CD 
      between January 2006 and December 2015. Postoperative complications were defined 
      as a Clavien-Dindo classification of grade 2A or higher within the first 30 days 
      after surgery. RESULTS: Of the 817 patients enrolled, 687 patients received bowel 
      resection and anastomosis without stoma formation. Of 687 patients, 381 (55.5%) 
      were being treated with preoperative medications at the time of surgery 
      (medication group) and 306 (44.5%) were not (nonmedication group). The overall 
      rate of postoperative complications was not different between the medication and 
      nonmedication groups (23.4% vs 21.9%, P = 0.36). Preoperative treatments with 
      immunomodulators plus anti-TNF-alpha agents (relative risk [RR], 2.314; 95% 
      confidence interval [CI], 1.126-4.753; P = 0.022) and treatment with 
      immunomodulators plus steroids (RR, 2.536; 95% CI, 1.124-5.725; P = 0.025) were 
      risk factors for infectious complications. Preoperative treatments with 
      immunomodulators plus anti-TNF-alpha agents (RR, 2.731; 95% CI, 1.102-6.769; P = 
      0.03) and treatment with immunomodulators plus steroids (RR, 3.118; 95% CI, 
      1.169-8.320; P = 0.023) were significantly associated with increased risk of 
      intra-abdominal sepsis. CONCLUSIONS: Preoperative treatments with 
      immunomodulators plus anti-TNF-alpha agents or steroids were risk factors for 
      infectious complications, especially intra-abdominal sepsis in patients who 
      underwent bowel resection and anastomosis.
CI  - (c) 2019 Crohn's & Colitis Foundation. Published by Oxford University Press. All 
      rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
FAU - Yu, Chang Sik
AU  - Yu CS
AD  - Departments of Surgery, University of Ulsan College of Medicine, Asan Medical 
      Center, Seoul, Korea.
FAU - Jung, Sung Woo
AU  - Jung SW
AD  - Departments of Surgery, University of Ulsan College of Medicine, Asan Medical 
      Center, Seoul, Korea.
FAU - Lee, Jong Lyul
AU  - Lee JL
AD  - Departments of Surgery, University of Ulsan College of Medicine, Asan Medical 
      Center, Seoul, Korea.
FAU - Lim, Seok-Byung
AU  - Lim SB
AD  - Departments of Surgery, University of Ulsan College of Medicine, Asan Medical 
      Center, Seoul, Korea.
FAU - Park, In Ja
AU  - Park IJ
AD  - Departments of Surgery, University of Ulsan College of Medicine, Asan Medical 
      Center, Seoul, Korea.
FAU - Yoon, Yong Sik
AU  - Yoon YS
AD  - Departments of Surgery, University of Ulsan College of Medicine, Asan Medical 
      Center, Seoul, Korea.
FAU - Kim, Chan Wook
AU  - Kim CW
AD  - Departments of Surgery, University of Ulsan College of Medicine, Asan Medical 
      Center, Seoul, Korea.
FAU - Yang, Suk-Kyun
AU  - Yang SK
AD  - Departments of Gastroenterology, University of Ulsan College of Medicine, Asan 
      Medical Center, Seoul, Korea.
FAU - Ye, Byong Duk
AU  - Ye BD
AD  - Departments of Gastroenterology, University of Ulsan College of Medicine, Asan 
      Medical Center, Seoul, Korea.
FAU - Park, Sang Hyoung
AU  - Park SH
AD  - Departments of Gastroenterology, University of Ulsan College of Medicine, Asan 
      Medical Center, Seoul, Korea.
FAU - Han, Minkyu
AU  - Han M
AD  - Departments of Clinical Epidemiology and Biostatistics, University of Ulsan 
      College of Medicine, Asan Medical Center, Seoul, Korea.
FAU - Kim, Jin Cheon
AU  - Kim JC
AD  - Departments of Surgery, University of Ulsan College of Medicine, Asan Medical 
      Center, Seoul, Korea.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Inflamm Bowel Dis
JT  - Inflammatory bowel diseases
JID - 9508162
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Immunologic Factors)
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
EIN - Inflamm Bowel Dis. 2019 Oct 18;25(11):e156. PMID: 31294782
MH  - Adult
MH  - Antibodies, Monoclonal/*adverse effects
MH  - Crohn Disease/*complications/drug therapy/surgery
MH  - Digestive System Surgical Procedures/*adverse effects
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Immunologic Factors/*adverse effects
MH  - Intestines/*surgery
MH  - Male
MH  - Postoperative Complications/chemically induced/*pathology
MH  - *Preoperative Care
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors
MH  - Young Adult
OTO - NOTNLM
OT  - Crohn's disease
OT  - anti-TNF-alpha agents
OT  - complication
OT  - immunomodulators
OT  - steroids
EDAT- 2019/02/13 06:00
MHDA- 2020/05/02 06:00
CRDT- 2019/02/13 06:00
PHST- 2018/08/01 00:00 [received]
PHST- 2019/02/13 06:00 [pubmed]
PHST- 2020/05/02 06:00 [medline]
PHST- 2019/02/13 06:00 [entrez]
AID - 5310372 [pii]
AID - 10.1093/ibd/izz010 [doi]
PST - ppublish
SO  - Inflamm Bowel Dis. 2019 Aug 20;25(9):1559-1568. doi: 10.1093/ibd/izz010.