Risk factors for upper and lower type prolonged postoperative ileus following surgery for Crohn’s disease

Pozios, Ioannis; Seeliger, Hendrik; Lauscher, Johannes C.; Stroux, Andrea; Weixler, Benjamin; Kamphues, Carsten; Beyer, Katharina; Kreis, Martin E.; Lehmann, Kai S.; Seifarth, Claudia

doi:10.1007/s00384-021-03969-9

Cited by 12 publications

(5 citation statements)

References 40 publications

(71 reference statements)

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“…It must be highlighted that the current study did not intend to identify such a link, and nearly a third of the patients did not have baseline FC measurements. Also, young age at diagnosis, disease location, and smoking were not found to be risk factors in the cases that were analyzed, even though other studies reported them as such (2,(27)(28)(29).…”

Section: Discussionmentioning

confidence: 76%

Small intestinal bacterial overgrowth is associated with clinical relapse in patients with quiescent Crohn’s disease: a retrospective cohort study

Wei¹,

Feng²,

Chen³

et al. 2022

Ann Transl Med

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Background: Crohn's disease (CD) is an irreversible inflammatory disorder, characterized by alternating periods of relapse and remission. It is particularly important to predict clinical relapses in patients with CD because patients in remission could relapse frequently in a randomized way. Small intestinal bacterial overgrowth (SIBO) is a symptom of gut microbial dysbiosis and is commonly observed in patients with CD, which may affect disease course. The present research was carried out to establish whether SIBO is linked to the subsequent clinical relapse of CD.Methods: This retrospective observational cohort research included consecutive patients (≥18 years) with quiescent CD who underwent lactulose hydrogen-methane breath test to diagnose SIBO managed at Jinling Hospital in China from January 2016 to June 2020. We assessed demographic data, laboratory parameters, SIBO and clinical characteristics including disease location and behavior, surgical history and current and previous medication at baseline and analyzed these data to identify factors associated with clinical relapse.Patients were followed up for 18 months and assessed for the Crohn's Disease Activity Index (CDAI) scores, treatment escalation, and disease progression to determine the primary endpoint of clinical relapse.Results: Of the 73 enrolled patients, 34 (46.6%) were positive for SIBO. Twenty-seven (37.0%) patients experienced clinical relapse within 18 months (median time of relapse: 13.9 months). SIBO in the relapse group was considerably elevated compared to the non-relapse group (63.0% vs. 37.0%, P=0.032). The multivariate Cox regression analysis showed that SIBO [hazard ratio (HR) 2.79, P=0.017] and penetrating disease behavior (HR 3.66, P=0.040) were the sole individual risk elements for relapse in patients with quiescent CD.Conclusions: This study indicated that SIBO was highly prevalent in patients with CD, and was independently linked to clinical relapse in quiescent patients. Detecting SIBO may be a valuable option for the prognostic assessment of patients in clinical remission.

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Section: Discussionmentioning

confidence: 76%

Small intestinal bacterial overgrowth is associated with clinical relapse in patients with quiescent Crohn’s disease: a retrospective cohort study

Wei¹,

Feng²,

Chen³

et al. 2022

Ann Transl Med

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“…The average period from surgery to bowel movement also depends upon the age, indication and duration of surgery performed, presence of Ryle's tube, period to initiation of mobilization, presence of abdominal drains and intraoperative bowel condition. The edematous bowel may have increased postoperative ileus [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and Patient Outcomes Associated With Immediate Post-operative Anasarca Following Major Abdominal Surgeries: A Prospective Observational Study From 2019 to 2021

Meena¹,

Sairam²,

Puranik³

et al. 2021

Cureus

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Introduction: Anasarca is well-known and refers to generalized edema caused by underlying clinical conditions and unknown risk factors in the patient. However, it is a relatively unexplored postoperative symptom following major abdominal surgeries. It is associated with poor patient outcomes in terms of delayed recovery and associated severe complications. Pedal edema is an early sign of post-operative anasarca, which progresses into an unfavorable clinical condition due to generalized edema followed by multiple organ dysfunction. Aim: This study aimed to assess risk factors and complications associated with postoperative anasarca among patients undergoing major abdominal surgery. Methods and material: The prospective observational study included 241 patients undergoing major abdominal surgeries from July 2019 to February 2021 in a tertiary care health centre in Rajasthan, India. Risk factors like age, nutritional parameters, addictions like smoking, alcohol intake, opium intake, leukocytosis, and Charlson Comorbidity Index were assessed. Postoperative complications were graded by the Clavien-Dindo grading system. Mean, standard deviation, percentages, Pearson’s Chi-square test and Student’s t-test were used to analyze the data. Results: The incidence of anasarca was found to be 29.87%. Nutritional risk screening (NRS) 2002 score, albumin, age > 60 years and raised leukocyte counts were found to significantly correlate (p-value <0.05) with the development of anasarca postoperatively. Postoperative complications, according to Clavien-Dindo grading, were 16.67% in grade I (p value=0.002), 13.89% in grade II (p-value =0.199), 1.39% in grade III (p value=0.049), 20.83% in grade IV (p value<0.001), and 41.67% in grade V (p value<0.001). Conclusion: Higher NRS 2002 score, low albumin levels, age > 60 years and raised leukocyte counts are significantly correlated with the development of postoperative anasarca. Postoperative anasarca is found to be a significant predictor of poor prognosis of patients undergoing major abdominal surgery.

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“…Seven retrospective studies analyzed incidence and risk factors for post-operative complications in CD patients undergoing bowel resection, showing that pre-operative anemia was associated with a higher risk of post-operative morbidity and mortality [172][173][174], higher risk of sepsis [160], surgical site infection [175] and post-surgical complications [176] such as prolonged postoperative ileus [177].…”

Section: Post-operative Recurrence and Surgery-related Complicationsmentioning

confidence: 99%

Nutrition, Nutritional Status, Micronutrients Deficiency, and Disease Course of Inflammatory Bowel Disease

Valvano,

Capannolo,

Cesaro

et al. 2023

Nutrients

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During the disease course, most Inflammatory Bowel Disease patients present a condition of malnutrition, undernutrition, or even overnutrition. These conditions are mainly due to suboptimal nutritional intake, alterations in nutrient requirements and metabolism, malabsorption, and excessive gastrointestinal losses. A suboptimal nutritional status and low micronutrient serum levels can have a negative impact on both induction and maintenance of remission and on the quality of life of Inflammatory Bowel Disease patients. We performed a systematic review including all the studies evaluating the connection between nutrition, nutrition status (including undernutrition and overnutrition), micronutrient deficiency, and both disease course and therapeutic response in Inflammatory Bowel Disease patients. This systematic review was performed using PubMed/MEDLINE and Scopus. Four main clinical settings concerning the effect of nutrition on disease course in adult Inflammatory Bowel Disease patients were analyzed (induction of remission, maintenance of remission, risk of surgery, post-operative recurrence, and surgery-related complications). Four authors independently reviewed abstracts and manuscripts for eligibility. 6077 articles were found; 762 duplicated studies were removed. Out of 412 full texts analyzed, 227 were included in the review. The evidence summarized in this review showed that many nutritional aspects could be potential targets to induce a better control of symptoms, a deeper remission, and overall improve the quality of life of Inflammatory Bowel Disease patients.

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Risk factors for upper and lower type prolonged postoperative ileus following surgery for Crohn’s disease

Cited by 12 publications

References 40 publications

Small intestinal bacterial overgrowth is associated with clinical relapse in patients with quiescent Crohn’s disease: a retrospective cohort study

Small intestinal bacterial overgrowth is associated with clinical relapse in patients with quiescent Crohn’s disease: a retrospective cohort study

Risk Factors and Patient Outcomes Associated With Immediate Post-operative Anasarca Following Major Abdominal Surgeries: A Prospective Observational Study From 2019 to 2021

Nutrition, Nutritional Status, Micronutrients Deficiency, and Disease Course of Inflammatory Bowel Disease

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