Laparoscopic ileo-colic resection and right hemicolectomy for Crohn’s disease and colon cancer: a preliminary comparative study on post-operative outcome

Tiberi, Alessandro; Pesi, Benedetta; Giudici, Francesco; Zambonin, Daniela; Nelli, Tommaso; Cupellini, Curzio; Ficari, Ferdinando; Cianchi, Fabio; Scaringi, Stefano

doi:10.1007/s13304-020-00769-8

Cited by 7 publications

(14 citation statements)

References 23 publications

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“…As the majority of our patients had previous abdominal surgery and a significant number of them were operated in an urgent setting, the number of laparoscopic procedures was small. Several studies report same or lower morbidity for laparoscopic surgery than open surgery for CD [20, 42-46]. In our experience, patients undergoing laparoscopic surgery indeed had a lower rate of complications, but due to the small number of events, it would be precipitated to draw any conclusion on this matter.…”

Section: Discussion/conclusionmentioning

confidence: 54%

Abdominal Surgery in Crohn’s Disease: Risk Factors for Complications

et al. 2020

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Introduction: Abdominal surgery in patients with Crohn’s disease (CD) is challenging, especially in the biologic era. The aim of this study was to evaluate factors associated with increased risk for postoperative complications in CD. Methods: A retrospective study was conducted with consecutive patients who underwent abdominal surgery for CD from January 2012 to January 2018. Results: Of 103 patients, 32% had postoperative complications. Gender, age, disease location and phenotype, hemoglobin and albumin levels, previous abdominal surgery, and preoperative optimization did not differ between the groups with or without complications. Thirty-five percent of the patients were under anti-TNF therapy, and this medication was not associated with increased risk for postoperative complications. Time since the onset of the disease was significantly higher in patients with complications (12.9 vs. 9.4, p = 0.04). In multivariate analysis, creation of ostomy and urgent surgery were the only variables independently associated with increased risk for complications (OR 3.2, 95% CI 1.12–9.46 and OR 2.94, 95% CI 0.98–9.09, respectively). Conclusion: Urgent surgery for CD should preferably be performed in specialized centers, and creation of stoma is not necessarily associated with lower rate of postoperative complications but rather less severe complications.

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Section: Discussion/conclusionmentioning

confidence: 54%

Abdominal Surgery in Crohn’s Disease: Risk Factors for Complications

et al. 2020

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“…Finally, 51 cohort studies [ 21 , 22 , 23 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 ] fulfilled the inclusion criteria, three [ 21 , 55 , 89 ] of which included at least two discrete data sets and were subjected to qualitative and quantitative analysis ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

The Effect of Anti-Tumor Necrosis Factor-Alpha Therapy within 12 Weeks Prior to Surgery on Postoperative Complications in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Cira

Weber

Wilhelm

et al. 2022

JCM

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The rate of abdominal surgical interventions and associated postoperative complications in inflammatory bowel disease (IBD) patients is still substantially high. There is an ongoing debate as to whether or not patients who undergo treatment with anti-tumor necrosis factor-alpha (TNF-α) agents may have an increased risk for general and surgical postoperative complications. Therefore, a systematic review and meta-analysis was conducted in order to assess the effect of anti-TNF-α treatment within 12 weeks (washout period) prior to abdominal surgery on 30-day postoperative complications in patients with IBD. The results of previously published meta-analyses examining the effect of preoperative anti-TNF-α treatment on postoperative complications reported conflicting findings which is why we specifically focus on the effect of anti-TNF-α treatment within 12 weeks prior to surgery. PubMed, Cochrane, Scopus, Web of Science, World Health Organization Trial Registry, ClinicalTrials.gov and reference lists were searched (June 1995–February 2022) to identify studies, investigating effects of anti-TNF-α treatment prior to abdominal surgery on postoperative complications in IBD patients. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated and subgroup analyses were performed. In this case, 55 cohort studies (22,714 patients) were included. Overall, postoperative complications (OR, 1.23; 95% CI, 1.04–1.45; p = 0.02), readmission (OR, 1.39; 95% CI, 1.11–1.73; p = 0.004), and intra-abdominal septic complications (OR, 1.89; 95% CI, 1.44–2.49; p < 0.00001) were significantly higher for anti-TNF-α-treated patients. Significantly higher intra-abdominal abscesses and readmission were found for anti-TNF-α-treated CD patients (p = 0.05; p = 0.002). Concomitant treatment with immunosuppressives in <50% of anti-TNF-α-treated patients was associated with significantly lower mortality rates (OR, 0.32; 95% CI, 0.12–0.83; p = 0.02). Anti-TNF-α treatment within 12 weeks prior to surgery is associated with higher short-term postoperative complication rates (general and surgical) for patients with IBD, especially CD.

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“…Those patients treated by previous open surgery were not candidate to laparoscopy. This approach would minimize and equalize the effect of laparoscopy among the different groups [38][39][40]. The effect of adjuvant therapy on postoperative recurrence is not in the aims of the present study.…”

Section: Discussionmentioning

confidence: 97%

“…Some limitations have to be considered in the interpretation of the study results: this is a retrospective analysis of a prospective database, from a single tertiary center, covering a long-term period of 25 years. If the surgical strategy has been maintained almost unchanged over the years, the surgical approach has been shifted from open to laparoscopic surgery, and the adjuvant medical therapy has been enriched with the addition of novel biological therapies [ 3 – 6 , 9 , 37 – 39 ]. However, laparoscopy was adopted for CD by the “Luigi Sacco” IBD Unit since 2007, but it was offered only to the patients at their first operation or those presenting with a recurrence after a previous laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%