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Abdominal Surgery in Crohn's Disease: Risk Factors for Complications
Cintia Mayumi Sakurai Kimura1, Arceu Scanavini Neto1, Natalia Sousa Freitas Queiroz2
1Department of Colon and Rectal Surgery, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
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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