Outcomes of ileocolic resection and right hemicolectomies for Crohn's patients in comparison with non-Crohn's patients and the impact of perioperative immunosuppressive therapy with biologics and steroids on inpatient complications

Meta‐analysis: peri‐operative anti‐TNFα treatment and post‐operative complications in patients with inflammatory bowel disease

“…Four studies reported a mixed cohort of IBD patients, one of which was excluded due to a low NOS score . Overall, 18 studies with 4659 participants were eligible for meta‐analysis . Infectious complication rates could be calculated for 16 of these studies, non‐infectious complications for 14, and total complication rates for 15 studies.…”

“…Study endpoints are also presented in Table S1. Infliximab was given in the 12 weeks prior to surgery in ten studies, 8 weeks prior in four studies, and permitted beyond 12 weeks but largely given within 12 weeks in four studies . Most studies that included patients with adalimumab and certolizumab did not specify the interval from last dose to surgery, except for one where it was given in the 4 weeks preceding surgery …”

“…Our meta‐analysis is the first to include data from mixed cohorts of IBD patients . We also include more recently published manuscripts and excluded lower quality studies …”

“…Most studies did not report clearly the interval between the last dose of anti‐TNFα therapy and surgery. Several studies included patients within a peri‐operative infliximab group if they had received the last dose within the 12 weeks of surgery . The study by Waterman et al .…”

Surgical management of IBD—from an open to a laparoscopic approach

“…One study found an increased complication rate in patients treated with infliximab, 61 but this finding is still highly controversial. 59,[62][63][64] Long-term outcomes Several factors related to the surgical technique might have a marked effect on longterm outcomes after ileocolic resection for Crohn's disease. One RCT that focused on the optimal width of surgical margins for resecting Crohn's disease showed that both clinical and surgical recurrence rates were similar after limited resec tion (2 cm margins) than after extended resection (12 cm margins).…”