Perioperative complications in inflammatory bowel disease

Abstract

Almost 50% of patients with inflammatory bowel disease (IBD) will undergo surgery for their disease at some stage of its clinical course. Complications seen following surgery may occur early or late in the postoperative period. Patient factors, including active inflammatory disease, malnutrition, and use of immunosuppressant medications, make these patients a challenging surgical group and at increased risk for surgical complications. The purpose of this review is to characterize the complications that are commonly seen following surgery in patients with IBD and to discuss the surgical and patient factors that may influence their development.

Inflammatory Bowel Disease: Perioperative Pharmacological Considerations

“…5 Laparoscopic surgery has been consistently associated with decreased postoperative length of stay and complication rate.…”

Reducing Colorectal Anastomotic Leakage with Tissue Adhesive in Experimental Inflammatory Bowel Disease

“…Approximately 20% to 30% of patients with chronic ulcerative colitis ultimately require surgical treatment, and 30% of them need a total colectomy within 5 years after diagnosis. [1][2][3] On top of a residual chance for relapse after operation, these patients still suffer substantial risks of short-and long-term surgical complications. An overall surgical complication rate approximating 30% to 40% has been reported, which may further increase in the infectious cases (68%) when patients receive high-dose steroids.…”

“…An overall surgical complication rate approximating 30% to 40% has been reported, which may further increase in the infectious cases (68%) when patients receive high-dose steroids. 3,4 A major course of the infectious complications is leakage at the anastomotic site. 3,5 Therefore, preventing the leakage is a major objective in the request for preventing postoperative complications.…”

“…3,4 A major course of the infectious complications is leakage at the anastomotic site. 3,5 Therefore, preventing the leakage is a major objective in the request for preventing postoperative complications. Unfortunately, effective strategies are still lacking to date.…”

Perioperative Corticosteroid Management for Patients with Inflammatory Bowel Disease

“…Although adrenal insufficiency was suspected because of postoperative hypotension, the majority of the associations were inconclusive with only 3 of the 57 reported cases fulfilling diagnostic criteria for adrenal insufficiency. 24 Given these potential risks, a clear understanding of the indications for perioperative corticosteroid administration relative to preoperative corticosteroid dosing and duration of therapy is essential. [1][2][3][4][5][9][10][11][12][13][14][15][16][17][18][19] Within patients with IBD, corticosteroid supplementation during and after colorectal surgery procedures has been shown to be highly variable, even within individual institutions.…”