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Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review

dc.contributor.authorQuaresma, Abel Botelho
dc.contributor.authorBarbosa Barauna, Fernanda da Silva
dc.contributor.authorTeixeira, Fabio Vieira
dc.contributor.authorSaad-Hossne, Rogerio [UNESP]
dc.contributor.authorKotze, Paulo Gustavo
dc.contributor.institutionUniv Oeste Santa Catarina UNOESC
dc.contributor.institutionPontificia Univ Catolica Parana PUCPR
dc.contributor.institutionGastrosaude Clin
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2021-06-26T02:54:28Z
dc.date.available2021-06-26T02:54:28Z
dc.date.issued2021-02-01
dc.description.abstractBackground: With the paradigm shift related to the overspread use of biological agents in the treatment of inflammatory bowel diseases (IBD), several questions emerged from the surgical perspective. Whether the use of biologicals would be associated with higher rates of postoperative complications in ulcerative colitis (UC) patients still remains controversial. Aims: We aimed to analyze the literature, searching for studies that correlated postoperative complications and preoperative exposure to biologics in UC patients, and synthesize these data qualitatively in order to check the possible impact of biologics on postoperative surgical morbidity in this population. Methods: Included studies were identified by electronic search in the PUBMED database according to the PRISMA (Preferred Items of Reports for Systematic Reviews and Meta-Analysis) guidelines. The quality and bias assessments were performed by MINORS (methodological index for non-randomized studies) criteria for non-randomized studies. Results: 608 studies were initially identified, 22 of which were selected for qualitative evaluation. From those, 19 studies (17 retrospective and two prospective) included preoperative anti-TNF. Seven described an increased risk of postoperative complications, and 12 showed no significant increase postoperative morbidity. Only three studies included surgical UC patients with previous use of vedolizumab, two retrospective and one prospective, all with no significant correlation between the drug and an increase in postoperative complication rates. Conclusions: Despite conflicting results, most studies have not shown increased complication rates after abdominal surgical procedures in patients with UC with preoperative exposure to biologics. Further prospective studies are needed to better establish the impact of preoperative biologics and surgical complications in UC.en
dc.description.affiliationUniv Oeste Santa Catarina UNOESC, Dept Colorectal Surg, BR-89600000 Joacaba, Brazil
dc.description.affiliationPontificia Univ Catolica Parana PUCPR, Colorectal Ssurgery Unit, BR-80215901 Curitiba, Parana, Brazil
dc.description.affiliationGastrosaude Clin, IBD Clin, BR-17509190 Marilia, SP, Brazil
dc.description.affiliationPaulista State Univ UNESP, Botucatu Med Sch, BR-18618687 Botucatu, SP, Brazil
dc.description.affiliationUnespPaulista State Univ UNESP, Botucatu Med Sch, BR-18618687 Botucatu, SP, Brazil
dc.format.extent15
dc.identifierhttp://dx.doi.org/10.3390/jcm10040710
dc.identifier.citationJournal Of Clinical Medicine. Basel: Mdpi, v. 10, n. 4, 15 p., 2021.
dc.identifier.doi10.3390/jcm10040710
dc.identifier.urihttp://hdl.handle.net/11449/210706
dc.identifier.wosWOS:000624037100001
dc.language.isoeng
dc.publisherMdpi
dc.relation.ispartofJournal Of Clinical Medicine
dc.sourceWeb of Science
dc.subjectulcerative colitis
dc.subjectantibodies
dc.subjectmonoclonal
dc.subjectpostoperative complications
dc.subjectinfections
dc.subjectnecrosis tumor factor-alpha
dc.subjectintegrins
dc.titleExploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Reviewen
dc.typeResenha
dcterms.rightsHolderMdpi
dspace.entity.typePublication
unesp.author.orcid0000-0002-8915-7279[3]
unesp.campusUniversidade Estadual Paulista (UNESP), Faculdade de Medicina, Botucatupt
unesp.departmentCirurgia e Ortopedia - FMBpt

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