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Updated: Feb 4, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
The Effect of Biologics on Postoperative Complications in Children With Inflammatory Bowel Disease and Bowel
Jennifer B Mitsuya1,2, Raquel Gonzalez3, Ron Thomas4
1Division of Pediatric Gastroenterology, Department of Pediatrics, Children's Hospital of Michigan.
Insights
Pediatric inflammatory bowel disease (IBD) patients treated with biologic agents before surgery had similar postoperative complication rates compared to those on nonbiologic therapy. This suggests biologics are safe for children with IBD undergoing bowel resection.
Area of Science:
- Pediatric Gastroenterology
- Surgical Outcomes
- Inflammatory Bowel Disease (IBD) Management
Background:
- Limited data exists on postoperative complications in pediatric inflammatory bowel disease (IBD) patients treated with biologic agents undergoing surgery.
- Previous studies in adults show mixed results regarding complications after operative management for IBD.
Purpose of the Study:
- To compare postoperative complication rates in pediatric IBD patients treated with biologic agents versus nonbiologic therapy before bowel resection.
- To assess the safety of biologic agents in children with IBD requiring surgical intervention.
Main Methods:
- A single-center, retrospective chart review of 62 pediatric IBD patients who underwent bowel resection between 2001 and 2017.
- Analysis included demographics, preoperative medications, surgical details, and postoperative complications (e.g., infections, abscesses, anastomotic leaks).
- Complications were compared between patients who received preoperative biologic therapy and those who did not.
Main Results:
- Out of 62 patients, 37 received biologic agents (infliximab, adalimumab, or vedolizumab) preoperatively.
- The overall postoperative complication rate was 6.45% (4 complications within 30 days).
- There were 2 complications in the biologic group and 2 in the nonbiologic group, with no significant difference.
Conclusions:
- The incidence of postoperative complications was similar in pediatric IBD patients treated with or without preoperative biologic agents.
- This study suggests that the use of biologic agents is safe in pediatric patients with IBD undergoing bowel resection.
Objectives:
There has been limited investigation of pediatric patients with inflammatory bowel disease (IBD) who have been treated with biologic agents and undergo operative management. Postoperative complications in the adult setting have been mixed and in the pediatric population the data have been limited. This study compares children with IBD treated with biologic agents to patients treated with nonbiologic therapy before bowel resection.
Methods:
This is a single-center, retrospective chart review study of 62 children with IBD who underwent bowel resection between 2001 and 2017. Analysis included patient demographics, medications used before surgery, incidence of postoperative complications, indication for surgery, type of operation, and additional surgeries required. Postoperative complications were defined as superficial skin infection, leak at anastomotic site, intra-abdominal abscess, wound dehiscence, and so on. Complications were compared based on medical therapy.
Results:
Of the 62 children reviewed, 21 carried the diagnosis of ulcerative colitis, 40 had Crohn disease, and 1 had IBD-unspecified. Thirty-seven of the patients were treated with infliximab, adalimumab, or vedolizumab before their bowel resection. There were 4 complications documented within 30 days of the operation, with an overall complication rate of 6.45%. There were 2 complications in each of the cohorts, including intra-abdominal abscess (2), abdominal wall abscess (1), and pouchitis (1).
Conclusion:
The number of complications was the same between those who did and did not receive a preoperative biologic agent. This study suggests that biologics may be safe to use in patients undergoing bowel resection.
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