Postoperative Morbidity After Iterative Ileocolonic Resection for Crohn’s Disease: Should we be Worried? A Prospective Multicentric Cohort Study of the GETAID Chirurgie - Archive ouverte HAL Access content directly
Journal Articles Journal of Crohn's and Colitis Year : 2019

Postoperative Morbidity After Iterative Ileocolonic Resection for Crohn’s Disease: Should we be Worried? A Prospective Multicentric Cohort Study of the GETAID Chirurgie

(1, 2) , (3) , (4) , (5) , (6) , (7) , (8) , (9) , (10) , (11) , (12) , (13) , (14) , (15) , (16, 17, 18, 19) , (20) , (21) , (22) , (23) , (15) , (3) , (24) , (2, 1)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Eddy Cotte
Eric Vicaut
Yves Panis

Abstract

BACKGROUND AND AIMS: To compare perioperative characteristics and outcomes between primary ileocolonic resection [PICR] and iterative ileocolic resection [IICR] for Crohn's disease [CD]. METHODS: From 2013 to 2015, 567 patients undergoing ileocolonic resection were prospectively included in 19 centres of the GETAID chirurgie group. Perioperative characteristics and postoperative results of both groups [431 PICR, 136 IICR] were compared. Uni- and multivariate analyses of the risk factors of overall 30-day postoperative morbidity was carried out in the IICR group. RESULTS: IICR patients were less likely to be malnourished [27.2% vs 39.9%, p = 0.007], and had more stricturing forms [69.1% vs 54.3%, p = 0.002] and less perforating disease [19.9% vs 39.2%, p < 0.001]. Laparoscopy was less commonly used in IICR [45.6% vs 84.5%, p < 0.01] and was associated with increased conversion rates [27.4% vs 14.6%, p = 0.012]. Overall postoperative morbidity was 36.8% in the IICR group and 26.7% in the PICR group [p = 0.024]. There was no significant difference between IICR and PICR regarding septic intra-abdominal complications, anastomotic leakage [8.8% vs 8.4%] or temporary stoma requirement. IICR patients were more likely to present with non-infectious complications and ileus [11.8% vs 3.7%, p < 0.001]. Uni- and multivariate analyses did not identify specific risk factors of overall postoperative morbidity in the IICR group. CONCLUSIONS: Surgery for recurrent CD is associated with a slight increase of non-infectious morbidity [postoperative ileus] that mainly reflects the technical difficulties of these procedures. However, IICR remains a safe therapeutic option in patients with recurrent CD because severe morbidity including anastomotic complications is similar to patients undergoing primary resection.
Fichier principal
Vignette du fichier
Abdalla et al. - 2019 - Postoperative Morbidity After Iterative Ileocoloni (1).pdf (260.02 Ko) Télécharger le fichier
Origin : Files produced by the author(s)
Loading...

Dates and versions

hal-02362759 , version 1 (22-01-2020)

Identifiers

Cite

Solafah Abdalla, Antoine Brouquet, Léon Maggiori, Philippe Zerbib, Quentin Denost, et al.. Postoperative Morbidity After Iterative Ileocolonic Resection for Crohn’s Disease: Should we be Worried? A Prospective Multicentric Cohort Study of the GETAID Chirurgie. Journal of Crohn's and Colitis, 2019, 13 (12), pp.1510-1517. ⟨10.1093/ecco-jcc/jjz091⟩. ⟨hal-02362759⟩
204 View
378 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More