The Effect of Biologics on Postoperative Complications in Children With Inflammatory Bowel Disease and Bowel Resection
| Autor: | Raquel Gonzalez, Mohammad El-Baba, Jennifer B. Mitsuya, Ron Thomas |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment Antibodies Monoclonal Humanized Inflammatory bowel disease Vedolizumab 03 medical and health sciences Biological Factors 0302 clinical medicine Postoperative Complications 030225 pediatrics medicine Humans Abscess Retrospective Studies Biological Products Wound dehiscence business.industry Gastroenterology Adalimumab Bowel resection Pouchitis medicine.disease Inflammatory Bowel Diseases Ulcerative colitis digestive system diseases Infliximab Surgery Case-Control Studies Pediatrics Perinatology and Child Health Preoperative Period 030211 gastroenterology & hepatology Female business medicine.drug |
| Zdroj: | Journal of pediatric gastroenterology and nutrition. 68(3) |
| ISSN: | 1536-4801 |
| Popis: | Objectives There has been limited investigation of pediatric patients with inflammatory bowel disease (IBD) who have been treated with biologic agents and undergo operative management. Postoperative complications in the adult setting have been mixed and in the pediatric population the data have been limited. This study compares children with IBD treated with biologic agents to patients treated with nonbiologic therapy before bowel resection. Methods This is a single-center, retrospective chart review study of 62 children with IBD who underwent bowel resection between 2001 and 2017. Analysis included patient demographics, medications used before surgery, incidence of postoperative complications, indication for surgery, type of operation, and additional surgeries required. Postoperative complications were defined as superficial skin infection, leak at anastomotic site, intra-abdominal abscess, wound dehiscence, and so on. Complications were compared based on medical therapy. Results Of the 62 children reviewed, 21 carried the diagnosis of ulcerative colitis, 40 had Crohn disease, and 1 had IBD-unspecified. Thirty-seven of the patients were treated with infliximab, adalimumab, or vedolizumab before their bowel resection. There were 4 complications documented within 30 days of the operation, with an overall complication rate of 6.45%. There were 2 complications in each of the cohorts, including intra-abdominal abscess (2), abdominal wall abscess (1), and pouchitis (1). Conclusion The number of complications was the same between those who did and did not receive a preoperative biologic agent. This study suggests that biologics may be safe to use in patients undergoing bowel resection. |
| Databáze: | OpenAIRE |
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