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Updated: Mar 18, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Postoperative Complications in Children With Crohn Disease Treated With Infliximab
Lori A Zimmerman1, Constantine G Saites, Sigrid Bairdain
1*IBD Center, Boston Children's Hospital, Boston, MA †Pediatric Surgical Associates, Minneapolis, MN ‡Department of Surgery, Boston Children's Hospital, Boston, MA.
Insights
Infliximab (IFX) therapy did not increase surgical complications or hospital stay for children with Crohn disease (CD) undergoing bowel resection. Further multicenter studies are needed to confirm these findings in pediatric CD patients.
Area of Science:
- Pediatric Gastroenterology
- Surgical Outcomes
- Inflammatory Bowel Disease
Background:
- Infliximab (IFX) is a key treatment for pediatric Crohn disease (CD).
- Despite IFX, many children with CD still need surgery.
- The impact of IFX on surgical complication risk in pediatric CD is not well understood.
Purpose of the Study:
- To compare surgical outcomes in children with CD who require bowel resection, stratified by IFX therapy.
- To evaluate the risk of postoperative complications in pediatric CD patients treated with IFX.
Main Methods:
- Retrospective review of 123 pediatric CD patients undergoing bowel resection with primary anastomosis (1977-2011).
- Analysis of demographics, medications, surgical procedures, and inpatient courses.
- Comparison of complication rates and length of stay between IFX-treated and non-IFX-treated groups.
Main Results:
- Overall postoperative complication rate was 13%.
- 24 of 123 patients received IFX preoperatively.
- No significant differences in major complication rates or postoperative length of stay were found between IFX-treated and non-IFX-treated groups.
Conclusions:
- Surgical interventions in pediatric CD patients treated with IFX were not associated with increased complications or prolonged hospital stays.
- Postoperative complications were infrequent in this pediatric cohort.
- Larger multicenter studies are recommended to definitively assess IFX's impact on surgical risk in pediatric CD.
Objectives:
Infliximab (IFX) has become a mainstay of therapy for children with Crohn disease (CD). Despite medical advances, many children with CD, however, still require operative interventions. The risk of complications following resection in children treated with IFX remains largely unknown. We compare surgical outcomes stratified by IFX therapy in a cohort of children with CD who require bowel resection.
Methods:
We reviewed the postoperative complications in 123 children with CD who underwent bowel resection with primary anastomosis at our institution between 1977 and 2011. Demographics, medications, types of operations, and inpatient courses were analyzed. Complications and length of stay were compared based on medical therapy.
Results:
Overall, the postoperative complication rate was 13%. Of the 123 surgical cases, 24 children had received IFX before their operation. In the children treated with IFX, we identified 3 major complications, including anastomotic leak, acute renal failure, and intraabdominal abscess. There were 9 major complications in the non-IFX group, including infections (2), intraabdominal abscesses (2), bowel obstruction, shock, supraventricular tachycardia, phlegmon, and anastomotic stricture. No significant differences in complication rates or postoperative lengths of stay were identified between those who did or did not receive IFX.
Conclusions:
In this cohort, surgical procedures in children and young adults treated with IFX were not associated with an increased number of complications or prolonged length of stay. Given that postoperative complications are infrequent in children, larger multicenter studies may be required to determine whether IFX therapy increases the risk of surgical complications in pediatric CD.
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