Inflammatory Bowel Disease Adversely Impacts Colorectal Cancer Surgery Short-term Outcomes and Health-Care Resource Utilization

Ramsey, Mitchell L.; Krishna, Somashekar G.; Stanich, Peter P.; Husain, Syed; Levine, Edward J.; Conwell, Darwin L.; Hinton, Alice; Zhang, Cheng

doi:10.1038/ctg.2017.54

Cited by 24 publications

(18 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With the rates of synchronous dysplasia and lesions, under ideal conditions, the surgical procedure of choice in IBD-CRC-both UC and CDis a total proctocolectomy (TPC) with ileal-pouch anal anastomosis (IPAA) [82]. These recommendations are consistent with population studies that demonstrate IBD-CRC patients-both UC and CD-were more likely to undergo total colectomy or total proctocolectomy than partial colectomy compared to non-IBD CRC patients [83]. In CD, segmental resection was formerly recommended, to spare bowel and fear of Crohn's disease of the pouch [84].…”

Section: % Of Respondents Consideredmentioning

confidence: 53%

“…Thus, IPAA can be recommended in select cases of CD as an alternative to total protocolectomy with definitive end-ileostomy, with the patient well informed of the risks, failure rates, and functional results [87,91]. infection and deep vein thrombosis, and were more likely to be readmitted within 30 days than sporadic CRC patients [83]. CD patients specifically were more likely to develop postoperative hemorrhage, hematoma or seroma, wound dehiscence, and poor wound healing [83].…”

Section: % Of Respondents Consideredmentioning

confidence: 99%

“…infection and deep vein thrombosis, and were more likely to be readmitted within 30 days than sporadic CRC patients [83]. CD patients specifically were more likely to develop postoperative hemorrhage, hematoma or seroma, wound dehiscence, and poor wound healing [83].…”

Section: % Of Respondents Consideredmentioning

confidence: 99%

See 2 more Smart Citations

Colorectal cancer in inflammatory bowel disease: review of the evidence

et al. 2019

View full text Add to dashboard Cite

Inflammatory bowel disease (IBD)-related colorectal cancer (CRC) is responsible for approximately 2% of the annual mortality from CRC overall, but 10%-15% of the annual deaths in IBD patients. IBD-related CRC patients are also affected at a younger age than sporadic CRC, and have a 5-year survival rate of 50%. Despite optimal medical treatment, the chronic inflammatory state inherent in IBD increases the risk for highgrade dysplasia and CRC, with additional input from genetic and environmental risk factors and the microbiome. Recognizing risk factors, implementing appropriate surveillance, and identifying high-risk patients is key to managing the CRC risk in IBD patients. Chemoprevention strategies exist, and studies evaluating their efficacy are underway. Once dysplasia or invasive cancer is diagnosed, appropriate surgical resection and post-operative treatment and surveillance are necessary. Here, we discuss the current state of IBD-related CRC, prevalence, risk factors, and evidence for surveillance, prophylaxis, and treatment recommendations.

show abstract

Section: % Of Respondents Consideredmentioning

confidence: 53%

Section: % Of Respondents Consideredmentioning

confidence: 99%

See 1 more Smart Citation

Colorectal cancer in inflammatory bowel disease: review of the evidence

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Its large sample size is ideal for developing national and regional estimates, and enables analyses of rare conditions, uncommon treatments, and special populations [11]. It has been used and validated in several studies to report reliable estimates of the burden and outcomes of gastrointestinal diseases [12-15].…”

Section: Methodsmentioning

confidence: 99%

Air embolism secondary to endoscopy in hospitalized patients: results from the National Inpatient Sample (1998-2013)

Olaiya

Adler

2019

aog

View full text Add to dashboard Cite

Background: Air embolism is a rare, but potentially catastrophic complication of endoscopic procedures. We herein evaluated the overall incidence of air embolism after endoscopy. We also measured mortality outcomes after air embolism. Methods: Patients who underwent endoscopy as an index procedure during hospitalization were selected from the National Inpatient Sample from 1998-2013. The primary outcome of interest was the incidence of air embolism after endoscopy. All-cause mortality after endoscopy was measured as a secondary outcome and the Charlson Comorbidity Index was calculated. Binary logistic regression was used to explore the effect of air embolism on inpatient mortality, using P<0.05 as level of significance. Results: A total of 2,245,291 patients met the inclusion criteria. Mean age at the time of procedure was 62.5 years. Esophagogastroduodenoscopy (EGD) was the most common endoscopic procedure, accounting for 80% of endoscopic procedures. Air embolism occurred in 13 cases, giving a rate of 0.57 per 100,000 endoscopic procedures. Air embolism was most common after endoscopic retrograde cholangiopancreatography (ERCP), occurring in 3.32 per 100,000 procedures, compared with 0.44 and 0.38 per 100,000 procedures for EGD and colonoscopy, respectively. The case fatality rate for post endoscopic air embolism was 15.4%. After adjusting for covariates, air embolism after endoscopy was independently associated with higher odds of inpatient mortality: odds ratio 10.35, 95% confidence interval 1.21-88.03 (P<0.03). Conclusions: Air embolism is most common after ERCP. It is frequently associated with disorders involving a breach to the gastrointestinal mucosa or vasculature. Though rare, it is an independent predictor of inpatient mortality.

show abstract

“…Further attention should be paid to patients with IBD undergoing CRC surgery. In fact, by comparing the hospital outcomes of CRC surgery between IBD and non-IBD patients, using data extracted from the National Inpatient Sample (2008–2012) and Nationwide Readmissions Database (2013), we found that IBD patients were more likely to develop DVT (adjusted odds ratio: 2.42, 95% CI: 1.36, 4.28) when compared to non-IBD patients with CRC [ 58 ]. In conclusion, maximum effort must be made by gastroenterologists and surgeons, especially in the phase prior to surgery, to minimize the risk factors for VTE.…”

Section: Surgerymentioning

confidence: 99%

Venous Thromboembolism in Patients with Inflammatory Bowel Disease: The Role of Pharmacological Therapy and Surgery

Papa

Tursi²,

Danese

et al. 2020

JCM

View full text Add to dashboard Cite

Patients with inflammatory bowel disease (IBD) have an increased risk of venous thromboembolism (VTE). Alongside the traditional acquired and genetic risk factors for VTE, patients with IBD have pathogenic and clinical peculiarities that are responsible for the increased number of thromboembolic events occurring during their life. A relevant role in modifying this risk in a pro or antithrombotic manner is played by pharmacological therapies and surgery. The availability of several biological agents and small-molecule drugs with different mechanisms of action allows us to also tailor the treatment based on the individual prothrombotic risk to reduce the occurrence of VTE. Available review articles did not provide sufficient and updated knowledge on this topic. Therefore, we assessed the role of each single treatment, including surgery, in modifying the risk of VTE in patients with IBD to provide physicians with recommendations to minimize VTE occurrence. We found that the use of steroids, particularly if prolonged, increased VTE risk, whereas the use of infliximab seemed to reduce such risk. The data relating to the hypothesized prothrombotic risk of tofacitinib were insufficient to draw definitive conclusions. Moreover, surgery has an increased prothrombotic risk. Therefore, implementing measures to prevent VTE, not only with pharmacological prophylaxis but also by reducing patient- and surgery-specific risk factors, is necessary. Our findings confirm the importance of the knowledge of the effect of each single drug or surgery on the overall VTE risk in patients with IBD, even if further data, particularly regarding newer drugs, are needed.

show abstract

Inflammatory Bowel Disease Adversely Impacts Colorectal Cancer Surgery Short-term Outcomes and Health-Care Resource Utilization

Cited by 24 publications

References 28 publications

Colorectal cancer in inflammatory bowel disease: review of the evidence

Colorectal cancer in inflammatory bowel disease: review of the evidence

Air embolism secondary to endoscopy in hospitalized patients: results from the National Inpatient Sample (1998-2013)

Venous Thromboembolism in Patients with Inflammatory Bowel Disease: The Role of Pharmacological Therapy and Surgery

Contact Info

Product

Resources

About