Infliximab does not affect postoperative complication rates in Crohn's patients undergoing abdominal surgery†
Part of this work was presented at the Meeting of the American Gastroenterological Association during the Digestive Disease Week in New Orleans, LA, on May 4th, 2010 and was published in abstract form (Gastroenterology 2010;138:S-532).
Abstract
Background:
In patients with Crohn's disease (CD), the effect of anti-tumor necrosis factor alpha (TNF-α) antibody therapy on postoperative complications remains unclear. We aimed to determine the effects of infliximab on postoperative complication rates in patients undergoing abdominal surgery for CD.
Methods:
Infliximab-treated CD patients undergoing abdominal surgery were identified in a prospective database. Gender- and age-matched CD patients without infliximab treatment served as controls. General and complication-related information was retrieved from patient records.
Results:
Forty-eight patients underwent abdominal surgery within 3 months (median 60 days, range 1–90 days) after infliximab administration (56% female, median age 35 years, range 17–66 years). Forty-eight patients without infliximab served as controls (50% female, 39 [17–68] years). Patient characteristics and number of minor complications were comparable between groups: wound infection (infliximab: 19% vs. controls: 15%), prolonged postoperative ileus (15% vs. 4%), and urinary tract infection (2% vs. 0%; all P > 0.05). No differences were found in major complications: anastomotic leakage (infliximab: 4% vs. controls: 13%), abscess formation (6% vs. 10%), bowel perforation (2% vs. 4%), stoma complication (6% vs. 2%), postoperative hemorrhage (8% vs. 2%), and enterocutaneous fistula (4% vs. 0%; all P > 0.05). One malnourished infliximab-treated patient with a complicated course of disease died postoperatively after anastomotic leakage, sepsis, and cardiac arrhythmia. Eleven infliximab and 10 control patients required reoperation (P > 0.05). Hospital stay was comparable between groups (infliximab: 13 [5–41] vs. controls: 12 [5–54] days; P > 0.05).
Conclusions:
Infliximab does not affect postoperative complication rates, suggesting no need to alter surgical management in these patients. (Inflamm Bowel Dis 2011;)
