Postoperative complications and waiting time for surgical intervention after radiologically guided drainage of intra-abdominal abscess in patients with Crohn's disease
| Autor: | Harel Jacoby, Antonino Spinelli, Angela Mujukian, A Minaya, Francesco Colombo, C A Rodríguez, J Warusavitarne, S Alonso, Nir Horesh, Ali Yalcinkaya, M L M Karer, N N Uldall Nielsen, F. Di Candido, Philip Fleshner, M Pera, N Qvist, Gianluca M. Sampietro, H M Al-Qaisi, M Ellebæk, L Kunovsky, Uri Kopylov, M V Marino, A G Granero, Alaa El-Hussuna, O C Tatar, Matteo Frasson, N Sørensen, N Ladwa, A Zeb, Igors Iesalnieks, Gianluca Pellino, Valerio Celentano, L Hurtado-Pardo, C Steenholdt |
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| Přispěvatelé: | El-Hussuna, A, Karer, M L M, Uldall Nielsen, N N, Mujukian, A, Fleshner, P R, Iesalnieks, I, Horesh, N, Kopylov, U, Jacoby, H, Al-Qaisi, H M, Colombo, F, Sampietro, G M, Marino, M V, 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, O C, Alonso, S, Pera, M, Granero, A G, Rodríguez, C A, Minaya, A, Spinelli, A, Qvist, N, Institut Català de la Salut, [El-Hussuna A, Karer MLM, Uldall Nielsen NN] Department of Clinical Medicin, Aalborg University, Aalborg, Denmark. [Mujukian A, Fleshner PR] Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA. [Iesalnieks I] Department of Surgery, Städtisches Klinikum München Bogenhausen, Munich, Germany. [Pellino G] Servei de Cirurgia Colorectal, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania ‘Luigi Vanvitelli’, Naples, Italy, Vall d'Hebron Barcelona Hospital Campus |
| Rok vydání: | 2021 |
| Předmět: |
Percutaneous
AcademicSubjects/MED00910 SURGERY Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Inflammatory Bowel Diseases::Crohn Disease [DISEASES] Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores] 0302 clinical medicine Crohn Disease Retrospective Studie Abscess Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess [DISEASES] PREOPERATIVE OPTIMIZATION RISK Mortality rate Abscessos Abdominal Abscess General Medicine enfermedades del sistema digestivo::enfermedades gastrointestinales::gastroenteritis::enfermedad inflamatoria intestinal::enfermedad de Crohn [ENFERMEDADES] 3. Good health Waiting List 030220 oncology & carcinogenesis Cohort PERCUTANEOUS DRAINAGE Drainage 030211 gastroenterology & hepatology Original Article Female AcademicSubjects/MED00010 Human Adult medicine.medical_specialty Waiting Lists infecciones bacterianas y micosis::infección::supuración::absceso::absceso abdominal [ENFERMEDADES] 03 medical and health sciences medicine Humans Other subheadings::Other subheadings::/diagnostic imaging [Other subheadings] Retrospective Studies Aged business.industry Abdominal Absce Otros calificadores::Otros calificadores::/diagnóstico por imagen [Otros calificadores] Retrospective cohort study Intra-abdominal Abscess Odds ratio medicine.disease Intestins - Inflamació - Complicacions Surgery business Other subheadings::Other subheadings::/complications [Other subheadings] INFLAMMATORY-BOWEL-DISEASE |
| Zdroj: | BJS Open r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria El-Hussuna, A, Karer, M L M, Uldall Nielsen, N N, Mujukian, A, Fleshner, P R, Iesalnieks, I, Horesh, N, Kopylov, U, Jacoby, H, Al-Qaisi, H M, Colombo, F, Sampietro, G M, Marino, M V, 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, O C, Alonso, S, Pera, M, Granero, A G, Rodríguez, C A, 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, vol. 5, no. 5, zrab075 . https://doi.org/10.1093/bjsopen/zrab075 El-Hussuna, A, Karer, M L M, Uldall Nielsen, N N, Mujukian, A, Fleshner, P R, Iesalnieks, I, Horesh, N, Kopylov, U, Jacoby, H, Al-Qaisi, H M, Colombo, F, Sampietro, G M, Marino, M V, 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, O C, Alonso, S, Pera, M, Granero, A G, Rodríguez, C A, Minaya, A, Spinelli, A, Qvist, N & OpenSourceResearch collaboration 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, vol. 5, no. 5, zrab075 . https://doi.org/10.1093/bjsopen/zrab075 Scientia |
| ISSN: | 2474-9842 |
| DOI: | 10.1093/bjsopen/zrab075 |
| Popis: | Background In patients with active Crohn’s disease (CD), treatment of intra-abdominal abscess usually comprises antibiotics and radiologically guided percutaneous drainage (PD) preceding surgery. The aim of this study was to investigate the risk of postoperative complications and identify the optimal time interval for surgical intervention after PD. Methods A multicentre, international, retrospective cohort study was carried out. Details of patients with diagnosis of CD who underwent ultrasonography- or CT-guided PD were retrieved from hospital records using international classification of disease (ICD-10) diagnosis code for CD combined with procedure code for PD. Clinical variables were retrieved and the following outcomes were measured: 30-day postoperative overall complications, intra-abdominal septic complications, unplanned intraoperative adverse events, surgical-site infections, sepsis and pathological postoperative ileus, in addition to abscess recurrence. Patients were categorized into three groups according to the length of the interval from PD to surgery (1–14 days, 15–30 days and more than 30 days) for comparison of outcomes. Results The cohort comprised 335 CD patients with PD followed by surgery. Median age was 33 (i.q.r. 24–44) years, 152 (45.4 per cent) were females, and median disease duration was 9 (i.q.r. 3.6–15) years. Overall, the 30-day postoperative complications rate was 32.2 per cent and the mortality rate was 1.5 per cent. After adjustment for co-variables, older age (odds ratio 1.03 (95 per cent c.i. 1.01 to 1.06), P < 0.012), residual abscess after PD (odds ratio 0.374 (95 per cent c.i. 0.19 to 0.74), P < 0.014), smoking (odds ratio 1.89 (95 per cent c.i. 1.01 to 3.53), P = 0.049) and low serum albumin concentration (odds ratio 0.921 (95 per cent c.i. 0.89 to 0.96), P < 0.001) were associated with higher rates of postoperative complications. A short waiting interval, less than 2 weeks after PD, was associated with a high incidence of abscess recurrence (odds ratio 0.59 (95 per cent c.i. 0.36 to 0.96), P = 0.042). Conclusion Smoking, low serum albumin concentration and older age were significantly associated with postoperative complications. An interval of at least 2 weeks after successful PD correlated with reduced risk of abscess recurrence. The authors showed that the optimal time interval for surgery is at least 2 weeks after drainage of the abscess. They confirmed the findings of other studies that smoking, steroid treatment and low albumin concentration in peripheral blood increase the risk of postoperative. |
| Databáze: | OpenAIRE |
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