The clinical impact of preoperative percutaneous drainage of abdominopelvic abscesses in patients with Crohn’s disease

Bafford, Andrea C; Coakley, Brian A.; Powers, Sarah; Greenwald, Daniel P.; Ha, Christina; Weintraub, Joshua; Chessin, David B.; Gorfine, Stephen R.; Bauer, Joel J.

doi:10.1007/s00384-011-1401-7

Cited by 21 publications

(2 citation statements)

References 35 publications

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“… 11 On the contrary, in a series by Bafford et al, preoperative treatment of CD abscess with PD did not decrease the rate of postoperative complications and the rate of stoma creation. 6 However, in Bafford's series, 31% of patients with technically successful PD had relapse of symptoms or abscess re-accumulation prior to surgery, whereas 26% of patients had clinical PD failure. The conflicting results among studies concerning PD may be explained by the fact that whether IAS was controlled by PD had a different impact on surgical outcome.…”

Section: Discussionmentioning

confidence: 91%

“…Treatment failure was categorized as technical failure or clinical failure, as defined by Bafford et al 6 (1) technical failures—those in which drainage was attempted, but not completed because of failure to aspirate fluid from abscess collections; and (2) clinical failures—those with persistent signs and symptoms of sepsis and incomplete abscess resolution on imaging, necessitating urgent/semiurgent surgery.…”

Section: Methodsmentioning

confidence: 99%

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Preoperative Intra-abdominal Sepsis, Not Penetrating Behavior Itself, Is Associated With Worse Postoperative Outcome After Bowel Resection for Crohn Disease

et al. 2015

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It is generally believed that penetrating behavior is associated with worse surgical outcomes in Crohn disease (CD). We hypothesized that intra-abdominal sepsis (IAS), but not penetrating behavior itself, contributes to postoperative morbidity in patients undergoing bowel resection for CD.Patients who underwent surgery from April 2010 to April 2014 were retrospectively identified from a prospectively maintained database. Demographic information and preoperative and operative data were collected. The outcomes following surgery in patients who had penetrating disease with or without IAS versus nonpenetrating CD were compared.Of 288 patients, 180 had penetrating CD, including 54 who had IAS. Preoperative characteristics were similar between the groups, except for serum albumin, abdominal drainage, and prior bowel resection. Patients with penetrating CD with IAS were more likely to have a stoma, surgical site complications, postoperative IAS complications, and major complications than patients with penetrating CD without IAS or nonpenetrating CD. There were no significant differences between patients with penetrating CD without IAS and nonpenetrating CD. The postoperative outcome was strengthened after propensity-score matching analysis. Moreover, penetrating CD with IAS (odds ratio [OR], 13.034; P = 0.004) is a risk predictor for major postoperative complications, and preoperative serum albumin (OR, 0.095; P = 0.002) and preoperative enteral nutrition (OR, 0.203, P = 0.049) are protective.Penetrating CD without IAS did not adversely affect postoperative outcome after bowel resection compared with penetrating CD with IAS. These results may revise the notion that all patients with penetrating CD have worse postoperative complications.

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Section: Discussionmentioning

confidence: 91%

Section: Methodsmentioning

confidence: 99%