Risk Factors for Postoperative Intra-abdominal Septic Complications after Bowel Resection in Patients with Crohn’s Disease

Kanazawa, Amane; Yamana, Tetsuo; Okamoto, Kinya; Sahara, Rikisaburo

doi:10.1097/dcr.0b013e3182617716

Cited by 89 publications

(57 citation statements)

References 16 publications

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“…These results are further complicated by a study including preoperative nutritional supplementation in patients with albumin less than 3.0 mg/dL (31). Moreover, albumin level less than 3.5 mg/dL (34,35) and less than 4.0 mg/dL (36) were reported to have no association with IASC. A recent meta-analysis using many of these described studies found a correlation with low albumin and increased risk of IASC (37), but the definition of low albumin is quite inconsistent in these studies making even the pooled results difficult to determine.…”

Section: Discussionmentioning

confidence: 81%

“…In contrast, abscess was not associated with abdominal complications in other studies (35,36). Some studies included abscesses that were drained preoperatively and found no association with abscess and postoperative IASC (36,41). A meta-analysis which included a large number of studies that discussed intra-abdominal abscess found an increased risk of IASC with intra-abdominal abscess.…”

Section: Discussionmentioning

confidence: 99%

“…However, the risk factors for intra-abdominal septic complications (IASCs) which involve an anastomotic leakage, intra-abdominal abscess, or enterocutaneous fistula, still remain controversial. Some risk factors related to higher rates of IASCs include the following: preoperative steroids use (13,14), preoperative abscess (13,14), poor nutritional status (14,15), low albumin levels (16), advanced age (17, 18), immune-modulating medications (19), the method of anastomosis (20), operating time (20,21), duration of symptoms leading to surgery (22,23), and a colo-colonic anastomosis.…”

Section: Introductionmentioning

confidence: 99%

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The Occurrence of Postoperative Complications in Patients Undergoing Surgery due to Complications from Crohn's Disease: A Case Report

Joksimovic¹,

Јankulovski²,

Antović³

et al. 2018

Acta Facultatis Medicae Naissensis

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S U M M A R YCrohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract that can give rise to strictures, inflammatory masses, fistulas, abscesses, hemorrhage, and cancer. This disease commonly affects the small bowel, colon, rectum or anus. Less commonly, it affects the stomach, esophagus and mouth. Often, the disease affects multiple areas of the gastrointestinal tract. The cause of CD is not known and there is no curative treatment. The current medical and surgical treatment is effective in controlling the disease, but even with optimal treatment, recurrences and relapses are frequent.Various risk factors specific for the patients with conditions related to the CD can influence the outcome of the surgical treatment in the postoperative period. Those risk factors can be preoperative laboratory inflammatory markers such as WBC and CRP values, phlegmona of the anterior abdominal wall and preoperative interintestinal abscess, positive resection margins.Here we present a case of a patient who was surgically treated as an emergent case because of the complication due to Crohn's disease. At presentation, the patient had leukocytosis, elevated CRP, anemia, low levels of total proteins, and albumin.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Occurrence of Postoperative Complications in Patients Undergoing Surgery due to Complications from Crohn's Disease: A Case Report

Joksimovic¹,

Јankulovski²,

Antović³

et al. 2018

Acta Facultatis Medicae Naissensis

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“…This high rate of morbidity is in relationship with long-term medical treatment: corticosteroid-therapy and immunosuppressive drugs. Risk factors for septic complications occurred post-operatively are: presence of abscess discovered during surgery, the severity of disease, perioperative malnutrition, long-term corticosteroidtherapy, Penetrating type, operation time >180 minutes, and handsewn anastomoses [27,50,51].…”

Section: The Early Postoperative Resultsmentioning

confidence: 99%

“…Side to side stapled anastomosis is as safe as conventional sutured end-to-end anastomosis and results in a lower incidence of symptomatic recurrent Crohn's disease and need for reoperation. [27,28]. For colonic lesions: segmental colonic, sub-total or total colonic resection.…”

Section: The Intestinal Resectionmentioning

confidence: 99%

Surgical Management of Primary Crohn’s Disease

Makni¹

2017

Austin J Gastroenterol

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Inflammatory bowel disease is a chronic gastrointestinal condition that is characterized by chronic gastrointestinal inflammation. The management of Crohn's disease is complex and requires skill, knowledge and experience with current advances in the field. Over the past several years, there have been a number of achievements and progress made in the care and management of this disorder. The diagnostic tools have greatly improved. The therapeutic armamentarium has expanded. The genetics of IBD has become more detailed and the role of the gut microbiome has been better defined. The evolution of biological agents has revolutionized the way we approach this disease. However, surgery is still required in more than 80% of patients with Crohn's disease (CD). This article aims to study the epidemiological, anatomical and therapeutic principles of surgical forms of CD. Keywords:Crohn's disease; Surgery; Recurrence; Stricture; Fistula IntroductionSurgery is required in more than 80% of patients with Crohn's disease (CD) [1]. The aim of surgery is not to cure the disease, which evolves in most cases to the recurrence of the remaining intestine [2]. Surgical treatment of intestinal lesions caused by CD is guided by two main criteria: operate only complicated forms, and refractory to medical treatment, and perform an intestinal resection as limited as possible, removing only lesions responsible for the symptoms observed. Indeed, perineal CD is problematic as regards to the diagnostic, prognostic and specific management. Over the past several years, there have been a number of achievements and progress made in the care and management of this disorder. However, surgery is still required in more than 80% of patients with Crohn's disease (CD). This article aims to study the epidemiological, anatomical and therapeutic principles of surgical forms of CD. The indications of surgical managementMultidisciplinary approach is now mandatory to discuss the therapeutic strategy and the time for surgery. The indication for surgery in CD depends on a number of factors-complications, clinical course, relapse and location. We could say that surgery is timely in any of the following situations: failure of medical treatment, onset of specific complications related to the disease or to pharmacological treatment, dysplasia or cancer and stagnated or retarded growth in children [3,4]. Chronic complications of Crohn's diseaseSurgery in the era of medical management: Today's, medical management (immunosuppressants, biological therapies) has been used increasingly and was initiated much earlier during the course of CD. However, this evolving therapeutic strategy was not associated with a decrease in the need for surgery or in a decrease of the occurrence of intestinal complications. The real benefit is that large intestinal resections became more unusual [5].Time for surgery: Identifying the best time for surgery is not always an easy task. In order to determine the best time for surgery

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Short- and medium-term outcomes following primary ileocaecal resection for Crohn's disease in two specialist centres

Overstraeten

Eshuis

Vermeire

et al. 2017

British Journal of Surgery

100

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Risk Factors for Postoperative Intra-abdominal Septic Complications after Bowel Resection in Patients with Crohn’s Disease

Cited by 89 publications

References 16 publications

The Occurrence of Postoperative Complications in Patients Undergoing Surgery due to Complications from Crohn's Disease: A Case Report

The Occurrence of Postoperative Complications in Patients Undergoing Surgery due to Complications from Crohn's Disease: A Case Report

Surgical Management of Primary Crohn’s Disease

Short- and medium-term outcomes following primary ileocaecal resection for Crohn's disease in two specialist centres

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