Presented as podium presentation at the 2010 ASCRS Annual Meeting in Minneapolis, MN, 15–19 May 2010. ACPGBI Annual Meeting.
Surgical resection in Crohn’s disease: is immunosuppressive medication associated with higher postoperative infection rates?
Article first published online: 12 OCT 2011
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland
Volume 13, Issue 11, pages 1294–1298, November 2011
How to Cite
Canedo, J., Lee, S.-H., Pinto, R., Murad-Regadas, S., Rosen, L. and Wexner, S. D. (2011), Surgical resection in Crohn’s disease: is immunosuppressive medication associated with higher postoperative infection rates?. Colorectal Disease, 13: 1294–1298. doi: 10.1111/j.1463-1318.2010.02469.x
- Issue published online: 12 OCT 2011
- Article first published online: 12 OCT 2011
- Accepted manuscript online: 22 OCT 2010 02:25PM EST
- Received 2 June 2010; accepted 3 September 2010; Accepted Article online 22 October 2010
- Crohn’s disease;
- infection rates
Aim The aim of this study was to analyse postoperative infection in patients undergoing surgery for Crohn’s disease (CD) according to the use of preoperative immunosuppressants, including infliximab.
Method With IRB approval, the records of all patients with CD who underwent abdominal surgery between 2001 and 2008 were reviewed for comorbidity, preoperative medication, type of surgery, stoma construction and postoperative complications. Patients were divided into three categories according to the preoperative medication within 90 days of surgery as follows: infliximab (IFX), other drugs including steroids and/or immunosuppressive agents (OD) and no drugs (ND).
Results Two hundred and twenty-five patients were identified. Preoperative comorbidity, surgical indication and type of surgery were not significantly different among the three groups. Ileocolic resection was the most common procedure [50.8%, IFX group; 61.2%, OD group; 41.3%, ND group (P = 0.09)]. Other procedures included total colectomy (16%), protectomy (15%) and others (18%). Laparoscopic surgery was performed in 47.7%, 45.9% and 29.3% of patients in the IFX, OD and ND groups, respectively (P = 0.04). There were no differences in postoperative rates of infection [pneumonia (P = 0.14), wound infection (P = 0.35), abscess (P = 0.34) or anastomotic leakage (P = 0.44)]. Reoperation was needed in 3.0%, 8.2% and 2.6% of patients in the IFX, OD and ND groups, respectively. Multiple logistic regression found no relationship between infliximab use and infection.
Conclusion There was no difference in the rate of postoperative complications among the groups of patients undergoing surgery for CD pretreated with IFX or other immunosuppressive drugs.