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

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dc.contributor.authorAvellaneda, Nicolás
dc.contributor.authorCoy, Claudio Saddy Rodrigues
dc.contributor.authorFillmann, Henrique Sarubbi
dc.contributor.authorSaad-Hossne, Rogerio [UNESP]
dc.contributor.authorMuñoz, Juan Pablo
dc.contributor.authorGarcía-Duperly, Rafael
dc.contributor.authorBellolio, Felipe
dc.contributor.authorRotholtz, Nicolás
dc.contributor.authorRossi, Gustavo
dc.contributor.authorMarquez, Juan Ricardo
dc.contributor.authorCillo, Mariano
dc.contributor.authorLacerda-Filho, Antonio
dc.contributor.authorCarrie, Augusto
dc.contributor.authorMaruyama, Beatriz Yuki
dc.contributor.authorFillmann, Lucio Sarubbi
dc.contributor.authorFerro, Ezequiel
dc.contributor.authorLondoño-Schimmer, Eduardo
dc.contributor.authorIglesias, Andrés
dc.contributor.authorHarriott, Camila Bras
dc.contributor.authorCampana, Juan Pablo
dc.contributor.authorEstrada, Daniel Londoño
dc.contributor.authorBalachandran, Rogini
dc.contributor.authorKotze, Paulo Gustavo
dc.contributor.institutionHospital Universitario CEMIC
dc.contributor.institutionAarhus University Hospital
dc.contributor.institutionUniversidade Estadual de Campinas (UNICAMP)
dc.contributor.institutionPontificia Universidad Católica de Rio Grande do Sul
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionNueva Proctología
dc.contributor.institutionFundación Santa Fé de Bogotá
dc.contributor.institutionPontíficia Universidad Católica de Chile
dc.contributor.institutionHospital Aleman de Buenos Aires
dc.contributor.institutionHospital Italiano de Buenos Aires
dc.contributor.institutionClínica Las Américas
dc.contributor.institutionHospital Británico de Buenos Aires
dc.contributor.institutionFelicio Rocho Hospital
dc.contributor.institutionPontificia Universidade Católica do Paraná (PUCPR)
dc.date.accessioned2023-07-29T15:12:54Z
dc.date.available2023-07-29T15:12:54Z
dc.date.issued2023-05-01
dc.description.abstractBackground: Early surgical resection is an emerging concept for patients with ileocaecal Crohn's disease (CD). The aim of this study was to compare postoperative outcomes after ileocaecal resections between patients with luminal and complicated CD. Methods: A retrospective analysis of patients operated for ileocaecal CD during an 8-year period in ten tertiary referral academic centres from Latin America was performed. Patients were allocated into 2 groups: those operated for early (luminal) disease (Early Crohn's Disease -ECD-) and for complications of CD (Complicated Crohn's disease -CCD-). A comparative analysis was performed regarding short-term outcomes of surgery, considering overall postoperative complications as main outcome. Results: 337 patients were included in the analysis, 60 (17.80%) in the ECD group. Smoking and exposure to perioperative biologic drugs were more prevalent in CCD group. CCD patients had increased requirement of urgent surgery (26.71 vs. 15%, p = 0.056), longer operative time (164.25 vs. 90.53 min, p< 0.01), lower rates of primary anastomosis (90.23 vs. 100%, p = 0.012), increased rate of overall postoperative complications (33.21 vs. 16.67%, p = 0.013), more reoperations (13.36 vs. 3.33%, p = 0.026), and higher rates of major anastomotic fistulas and hospital stay. On multivariable analysis, smoking (p = 0.001,95%CI: 2.59–32.11), operative time (p = 0.022,95%CI:1–1.02), associated procedures (p = 0.036,95%CI:1.09–15.72) and intraoperative complications (p = 0.021,95%CI:1.45–92.31) were independently related to presenting postoperative complications. Conclusion: Early (luminal) ileocaecal resections were associated to lower rates of overall postoperative complications. Proper timing for surgery, avoiding delays in surgical indication can impact postoperative outcomes.en
dc.description.affiliationGeneral Surgery Department Hospital Universitario CEMIC, Argentina. Galván 4102, C1431 CABA
dc.description.affiliationColorectal Surgery Department Aarhus University Hospital, Denmark. Palle Juul-Jensens Blvd. 161
dc.description.affiliationColorectal Surgery Unit Campinas State University (UNICAMP), Campinas, Brazil. Cidade Universitária Zeferino Vaz - Barão Geraldo, SP
dc.description.affiliationSurgery Department Pontificia Universidad Católica de Rio Grande do Sul, Brasil. Av. Ipiranga, 6681-Partenon, RS
dc.description.affiliationColorectal Surgery Department Paulista State University UNSEP, Brazil. Rua Quirino de Andrade, 215-Centro, SP
dc.description.affiliationColorectal Surgery Department Nueva Proctología, Argentina. Marcelo T. de Alvear 1419, C1060, CABA
dc.description.affiliationColorectal Surgery Department Fundación Santa Fé de Bogotá, Colombia. Carrera 7 No. 117 – 15
dc.description.affiliationColoproctology Unit Digestive Surgery Department Pontíficia Universidad Católica de Chile, Chile. Av. Libertador Bernardo O'Higgins 340, Región Metropolitana
dc.description.affiliationColorectal Surgery Service General Surgery Department Hospital Aleman de Buenos Aires, Argentina. Av. Pueyrredón 1640, C1118, CABA
dc.description.affiliationSection of Colorectal Surgery Department of General Surgery Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199 CABA
dc.description.affiliationColoproctology Institute Clínica Las Américas, Colombia. Diagonal 75B N. 2A-80/140
dc.description.affiliationColorectal Surgery Department Hospital Británico de Buenos Aires, Argentina. Perdriel 74
dc.description.affiliationDepartment of Colorectal Surgery Felicio Rocho Hospital, Av. do Contorno, 9530-Barro Preto-Belo Horizonte
dc.description.affiliationColorectal Surgery Unit Pontificia Universidade Católica do Paraná (PUCPR), R. Imac. Conceição, 1155-Prado Velho
dc.description.affiliationUnespColorectal Surgery Department Paulista State University UNSEP, Brazil. Rua Quirino de Andrade, 215-Centro, SP
dc.format.extent589-594
dc.identifierhttp://dx.doi.org/10.1016/j.dld.2022.09.011
dc.identifier.citationDigestive and Liver Disease, v. 55, n. 5, p. 589-594, 2023.
dc.identifier.doi10.1016/j.dld.2022.09.011
dc.identifier.issn1878-3562
dc.identifier.issn1590-8658
dc.identifier.scopus2-s2.0-85140990721
dc.identifier.urihttp://hdl.handle.net/11449/249323
dc.language.isoeng
dc.relation.ispartofDigestive and Liver Disease
dc.sourceScopus
dc.subjectColectomy
dc.subjectCrohn's disease
dc.subjectPostoperative complications
dc.subjectSurgery
dc.titleEarlier surgery is associated to reduced postoperative morbidity in ileocaecal Crohn's disease: Results from SURGICROHN – LATAM studyen
dc.typeArtigo
unesp.author.orcid0000-0002-6802-7125 0000-0002-6802-7125[1]

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