Earlier surgery is associated to reduced postoperative morbidity in ileocaecal Crohn's disease: Results from SURGICROHN – LATAM study

Avellaneda, Nicolás; Rodrigues, Claudio Coy Saddy; Fillmann, Henrique Sarubbi; Saad-Hossne, Rogério; Muñoz, Juan Pablo Artero; García-Duperly, Rafael; Bellolio, Felipe; Rotholtz, Nicolás A.; Rossi, Gustavo; Márquez, Juan Ricardo; Cillo, Mariano; Lacerda‐Filho, Antônio; Carrie, Augusto; Maruyama, Beatriz Yuki; Fillmann, Lúcio Sarubbi; Ferro, Ezequiel; Londoño-Schimmer, Eduardo; Iglesias, Andrés; Harriott, Camila Bras; Campana, Juan Pablo; Estrada, Daniel Londoño; Balachandran, Rogini; Kotze, Paulo Gustavo

doi:10.1016/j.dld.2022.09.011

Cited by 10 publications

(3 citation statements)

References 15 publications

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“…However, the Argentinian attempt to start a national prospective registry of colorectal cancer patients is an initiative that can be added to several projects coming from Latin America lately in this particular field, directed to create and analyse data to improve the results of healthcare practice in the medium and long term. Some initiatives that are worth mentioning are the creation of a regional Colorectal Surgery Consortium [25], the Surgicrohn-LATAM study [26] and a retrospective assessment of outcomes of right colectomies for countries in 11 Latin American countries including information from 2673 patients [27].…”

Section: Discussionmentioning

confidence: 99%

Starting a national, prospective colorectal cancer registry in a developing country: how to do it, potential limitations and results of a pilot study

2023

Colorectal Disease

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AimProspective registries of patients operated on for malignancies at a national scale are not common in developing countries. The aim of this work is to report the process of creation of a prospective national colorectal cancer registry in a middle‐income country in Latin America and the main results of a pilot study involving eight centres.MethodThe project involved the creation of a national database including all patients operated on for colorectal cancer in Argentina and a 30‐year plan to make improvements based on the information provided by the registry. The first phase comprised the prospective registration of all patients treated in eight tertiary referral centres during a 6‐month period.ResultsThree hundred and seventeen patients were prospectively recruited during the study period, and 244 (77%) were operated on for colon cancer. The completion rate for all variables was >95%. The median age for the group was 66.88 years. Right‐sided colon tumours were the most frequent. Colorectal specialists performed 257 (81.07%) of the procedures, and in 273 (87.22%) patients a laparoscopic approach was used with an overall conversion rate of 12.45%. Major complication and anastomotic leakage rates for the group were 18.55% and 8.81%, respectively. The mortality rate was 1.94%. Multivariate analysis showed that young patients and operations performed by general surgeons were the most common factors independently related to worse postoperative outcomes. Note that this manuscript describes an early phase of the project that included only eight tertiary referral centres.ConclusionDespite its limitations, this study describes the effort made to generate reliable data on which to base future decisions to improve patient care. Furthermore, it might set an example for other developing countries to start their own registries.

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Section: Discussionmentioning

confidence: 99%

Starting a national, prospective colorectal cancer registry in a developing country: how to do it, potential limitations and results of a pilot study

2023

Colorectal Disease

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“…Recently, the LIR!C group presented evidence suggesting that surgery could be a reasonable alternative to biologicals in patients with a limited (<40 cm) inflammatory phenotype at the terminal ileum in terms of 5-year recurrence rate, quality of life and costs to the healthcare system [5][6][7]. Furthermore, there is ongoing research looking at the short-and long-term outcomes after ileocaecal resection for purely luminal disease [8,9]. Increasingly, evidence is being published calling for reconsideration of the timing of surgery in patients with CD limited to the ileocaecal region [10,11].…”

Section: Unfavourable Postoperative Outcomes Have Been Reportedmentioning

confidence: 99%

Short‐term outcomes of surgical treatment for primary ileocaecal Crohn's disease: Results of the Crohn's(urg) study, a multicentre, retrospective, comparative analysis between inflammatory and complicated phenotypes

Avellaneda,

Pellino,

Maroli

et al. 2024

Colorectal Disease

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AimRecent evidence challenges the current standard of offering surgery to patients with ileocaecal Crohn's disease (CD) only when they present complications of the disease. The aim of this study was to compare short‐term results of patients who underwent primary ileocaecal resection for either inflammatory (luminal disease, earlier in the disease course) or complicated phenotypes, hypothesizing that the latter would be associated with worse postoperative outcomes.MethodA retrospective, multicentre comparative analysis was performed including patients operated on for primary ileocaecal CD at 12 referral centres. Patients were divided into two groups according to indication of surgery for inflammatory (ICD) or complicated (CCD) phenotype. Short‐term results were compared.ResultsA total of 2013 patients were included, with 291 (14.5%) in the ICD group. No differences were found between the groups in time from diagnosis to surgery. CCD patients had higher rates of low body mass index, anaemia (40.9% vs. 27%, p < 0.001) and low albumin (11.3% vs. 2.6%, p < 0.001). CCD patients had longer operations, lower rates of laparoscopic approach (84.3% vs. 93.1%, p = 0.001) and higher conversion rates (9.3% vs. 1.9%, p < 0.001). CCD patients had a longer hospital stay and higher postoperative complication rates (26.1% vs. 21.3%, p = 0.083). Anastomotic leakage and reoperations were also more frequent in this group. More patients in the CCD group required an extended bowel resection (14.1% vs. 8.3%, p: 0.017). In multivariate analysis, CCD was associated with prolonged surgery (OR 3.44, p = 0.001) and the requirement for multiple intraoperative procedures (OR 8.39, p = 0.030).ConclusionIndication for surgery in patients who present with an inflammatory phenotype of CD was associated with better outcomes compared with patients operated on for complications of the disease. There was no difference between groups in time from diagnosis to surgery.

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“…An example, the SURGICROHN-LATAM study was a multicenter study that evaluated surgical complications in patients with CD undergoing early versus late ileocolonic resections in 10 tertiary centers from Argentina, Brazil, Chile, and Colombia. 81 Strategies that promote international research collaboration can be fostered through a partnership between local IBD study groups. A list of the most important IBD study groups in LATAM is found in Table 3 .…”

Section: Areas For Research Opportunitiesmentioning

confidence: 99%

IBD barriers across the continents: a continent-specific analysis: Latin America

Queiroz

Martins

Quaresma

et al. 2023

Therap Adv Gastroenterol

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Latin America (LATAM) is a large region comprising 47 countries and territories. Each one carries a different cultural and historical background, diverse political systems, and a particular approach to healthcare management. There is a lack of high-quality data on the epidemiology of inflammatory bowel diseases (IBD) in this region, including broad and detailed information about the penetration of biological and advanced therapies as treatment strategies. From an IBD perspective, patients experience, in general, fragmentations and inequities in the healthcare systems, with different and usually delayed access to qualified health services. This review explores the barriers to accessing IBD care throughout LATAM. The authors compiled data from multiple sources, such as studies focusing on epidemiology, biological penetration, and surgical rates. In addition, overall access to IBD treatments was assessed through a questionnaire distributed to physicians in LATAM via email and direct messaging to capture local perspectives.

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Earlier surgery is associated to reduced postoperative morbidity in ileocaecal Crohn's disease: Results from SURGICROHN – LATAM study

Cited by 10 publications

References 15 publications

Starting a national, prospective colorectal cancer registry in a developing country: how to do it, potential limitations and results of a pilot study

Starting a national, prospective colorectal cancer registry in a developing country: how to do it, potential limitations and results of a pilot study

Short‐term outcomes of surgical treatment for primary ileocaecal Crohn's disease: Results of the Crohn's(urg) study, a multicentre, retrospective, comparative analysis between inflammatory and complicated phenotypes

IBD barriers across the continents: a continent-specific analysis: Latin America

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