High complication rate in Crohn's disease surgery following percutaneous drainage of intra-abdominal abscess: a multicentre study.
Colorectal surgery
Crohn’s disease
Inflammatory bowel disease
Intra-abdominal abscess
Journal
International journal of colorectal disease
ISSN: 1432-1262
Titre abrégé: Int J Colorectal Dis
Pays: Germany
ID NLM: 8607899
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
accepted:
10
05
2022
pubmed:
23
5
2022
medline:
9
6
2022
entrez:
22
5
2022
Statut:
ppublish
Résumé
Intra-abdominal abscesses complicating Crohn's disease (CD) present an additional challenge as their presence can contraindicate immunosuppressive treatment whilst emergency surgery is associated with high stoma rate and complications. Treatment options include a conservative approach, percutaneous drainage, and surgical intervention. The current multicentre study audited the short-term outcomes of patients who underwent preoperative radiological drainage of intra-abdominal abscesses up to 6 weeks prior to surgery for ileocolonic CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing ileocolic resection for primary or recurrent CD from June 2018 to May 2019. The outcomes of patients who underwent radiological guided drainage prior to ileocolonic resection were compared to the patients who did not require preoperative drainage. Postoperative morbidity within 30 days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. Amongst a group of 575 included patients who had an ileocolic resection for CD, there were 36 patients (6.2%) who underwent abscess drainage prior to surgery. Postoperative morbidity (44.4%) and anastomotic leak (11.1%) were significantly higher in the group of patients who underwent preoperative drainage. Patients with Crohn's disease who require preoperative radiological guided drainage of intra-abdominal abscesses are at increased risk of postoperative morbidity and septic complications following ileocaecal or re-do ileocolic resection.
Identifiants
pubmed: 35599268
doi: 10.1007/s00384-022-04183-x
pii: 10.1007/s00384-022-04183-x
pmc: PMC9167187
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1421-1428Investigateurs
Valerio Celentano
(V)
Gianluca Pellino
(G)
Matteo Rottoli
(M)
Gilberto Poggioli
(G)
Giuseppe Sica
(G)
Mariano Cesare Giglio
(MC)
Michela Campanelli
(M)
Claudio Coco
(C)
Gianluca Rizzo
(G)
Francesco Sionne
(F)
Francesco Colombo
(F)
Gianluca Sampietro
(G)
Giulia Lamperti
(G)
Diego Foschi
(D)
Ferdinando Ficari
(F)
Ludovica Vacca
(L)
Marta Cricchio
(M)
Francesco Giudici
(F)
Lucio Selvaggi
(L)
Guido Sciaudone
(G)
Roberto Peltrini
(R)
Andrea Manfreda
(A)
Luigi Bucci
(L)
Raffaele Galleano
(R)
Omar Ghazouani
(O)
Luigi Zorcolo
(L)
Simona Deidda
(S)
Angelo Restivo
(A)
Andrea Braini
(A)
Francesca Di Candido
(F)
Matteo Sacchi
(M)
Michele Carvello
(M)
Stefania Martorana
(S)
Giovanni Bordignon
(G)
Imerio Angriman
(I)
Angela Variola
(A)
Mirko Di Ruscio
(M)
Giuliano Barugola
(G)
Andrea Geccherle
(A)
Francesca Paola Tropeano
(FP)
Gaetano Luglio
(G)
Marta Tanzanu
(M)
Diego Sasia
(D)
Marco Migliore
(M)
Maria Carmela Giuffrida
(MC)
Enrico Marrano
(E)
Gianluigi Moretto
(G)
Harmony Impellizzeri
(H)
Gaetano Gallo
(G)
Giuseppina Vescio
(G)
Giuseppe Sammarco
(G)
Giovanni Terrosu
(G)
Giacomo Calini
(G)
Andrea Bondurri
(A)
Anna Maffioli Md
(A)
Gloria Zaffaroni
(G)
Andrea Resegotti
(A)
Massimiliano Mistrangelo
(M)
Marco Ettore Allaix
(ME)
Fiorenzo Botti
(F)
Matteo Prati
(M)
Luigi Boni
(L)
Serena Perotti
(S)
Michela Mineccia
(M)
Antonio Giuliani
(A)
Lucia Romano
(L)
Giorgio Maria Paolo Graziano
(GMP)
Luigi Pugliese
(L)
Andrea Pietrabissa
(A)
Gian Gaetano Delaini
(GG)
Antonino Spinelli
(A)
Francesco Selvaggi
(F)
Informations de copyright
© 2022. The Author(s).
Références
Maaser C, Sturm A, Vavricka SR, Kucharzik T, Fiorino G, Annese V, Calabrese E, Baumgart DC, Bettenworth D, Borralho Nunes P, Burisch J, Castiglione F, Eliakim R, Ellul P, González-Lama Y, Gordon H, Halligan S, Katsanos K, Kopylov U, Kotze PG, Krustinš E, Laghi A, Limdi JK, Rieder F, Rimola J, Taylor SA, Tolan D, van Rheenen P, Verstockt B, Stoker J (2019) European Crohn’s and Colitis Organisation [ECCO] and the European Society of Gastrointestinal and Abdominal Radiology [ESGAR] ECCO-ESGAR guideline for diagnostic assessment in IBD part 1: initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis 13(2):144–164. https://doi.org/10.1093/ecco-jcc/jjy113
doi: 10.1093/ecco-jcc/jjy113
pubmed: 30137275
Yamaguchi A, Matsui T, Sakurai T, Ueki T, Nakabayashi S, Yao T, Futami K, Arima S, Ono H (2004) The clinical characteristics and out- come of intraabdominal abscess in Crohn’s disease. J Gastroenterol 39:441–448. https://doi.org/10.1007/s00535-003-1409-z
doi: 10.1007/s00535-003-1409-z
pubmed: 15175942
He X, Lin X, Lian L, Huang J, Yao Q, Chen Z, Fan D, Wu X, Lan P (2015) Preoperative percutaneous drainage of spontaneous intra-abdominal abscess in patients with Crohn’s disease: a meta-analysis. J Clin Gastroenterol 49(9):e82-90
doi: 10.1097/MCG.0000000000000219
SICCR Current Status of Crohn’s Disease Surgery Collaborative (2020) National variations in perioperative assessment and surgical management of Crohn’s disease: a multicentre study. Colorectal Dis. Online ahead of print. https://doi.org/10.1111/codi.15334
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2008) STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4):344–9
IBD Standards Group (2013) Standards for the healthcare of people who have inflammatory bowel disease [IBD]. 2013 update. St Albans, UK: Oyster Healthcare Communications
NICE Quality Standard [QS81]—Inflammatory bowel disease. Published 6 February 2015. Last accessed 7/1/2022 http://www.nice.org.uk/guidance/qs81/chapter/quality-statement-2-multidisciplinary-team-support
Calvet X, Panes J, Alfaro N et al (2014) Delphi consensus statement: quality indicators for inflammatory bowel disease comprehensive care units. J Crohns Colitis 8:240–251
doi: 10.1016/j.crohns.2013.10.010
Feagins LA, Holubar SD, Kane SV, Spechler SJ (2011) Current strategies in the management of intra-abdominal abscesses in Crohn’s disease. Clin Gastroenterol Hepatol 9:842–850. https://doi.org/10.1016/j.cgh.2011.04.023
doi: 10.1016/j.cgh.2011.04.023
pubmed: 21679776
Caiazzo A, Flashman K, Celentano V (2020) Increased postoperative use of computed tomography following emergency surgery for ileocaecal Crohn disease. Surg Laparosc Endosc Percutan Tech 30(3):214–217
doi: 10.1097/SLE.0000000000000778
Xie Y, Zhu W, Li N et al (2012) The outcome of initial percutaneous drainage versus surgical drainage for intra-abdominal abscesses in Crohn’s disease. Int J Colorectal Dis 27:199–206
doi: 10.1007/s00384-011-1338-x
Zerbib P, Koriche D, Truant S et al (2010) Pre-operative management is associated with low rate of post-operative morbidity in penetrating Crohn’s disease. Aliment Pharmacol Ther 32:459–465
doi: 10.1111/j.1365-2036.2010.04369.x
Waked B, Holvoet T, Geldof J, Baert F, Pattyn P, Lobatón T, Hindryckx P (2021) Conservative management of spontaneous intra-abdominal abscess in Crohn’s disease: outcome and prognostic factors. J Dig Dis 22(5):263–270
doi: 10.1111/1751-2980.12984
Clancy C, Boland T, Deasy J, McNamara D, Burke JP (2016) A Meta-analysis of percutaneous drainage versus surgery as the initial treatment of Crohn’s disease-related intra-abdominal abscess. J Crohns Colitis 10(2):202–208
doi: 10.1093/ecco-jcc/jjv198
El-Hussuna A, Karer MLM, Uldall Nielsen NN, Mujukian A, Fleshner PR, Iesalnieks I, Horesh N, Kopylov U, Jacoby H, Al-Qaisi HM, Colombo F, Sampietro GM, Marino MV, Ellebæk M, Steenholdt C, Sørensen N, Celentano V, Ladwa N, Warusavitarne J, Pellino G, Zeb A, Di Candido F, Hurtado-Pardo L, Frasson M, Kunovsky L, Yalcinkaya A, Tatar OC, Alonso S, Pera M, Granero AG, Rodríguez CA, Minaya A, Spinelli A, Qvist N (2021) Postoperative complications and waiting time for surgical intervention after radiologically guided drainage of intra-abdominal abscess in patients with Crohn’s disease. BJS Open 5(5):zrab075. https://doi.org/10.1093/bjsopen/zrab075
Ghoneima AS, Flashman K, Dawe V, Baldwin E, Celentano V (2019) High risk of septic complications following surgery for Crohn’s disease in patients with preoperative anaemia, hypoalbuminemia and high CRP. Int J Colorectal Dis 34(12):2185–2188
doi: 10.1007/s00384-019-03427-7
Collard MK, Benoist S, Maggiori L, Zerbib P, Lefevre JH, Denost Q, Germain A, Cotte E, Beyer-Berjot L, Corté H, Desfourneaux V, Rahili A, Duffas JP, Pautrat K, Denet C, Bridoux V, Meurette G, Faucheron JL, Loriau J, Souche R, Vicaut E, Panis Y, Brouquet A (2021) A reappraisal of outcome of elective surgery after successful non-operative management of an intra-abdominal abscess complicating ileocolonic Crohn’s disease: a subgroup analysis of a nationwide prospective cohort. J Crohns Colitis 15(3):409–418
doi: 10.1093/ecco-jcc/jjaa217