One in Four Have Early Postoperative Complications After Ileocolonic Resection for Crohn’s

About one-quarter of patients who underwent intestinal resection for Crohn’s disease experienced postoperative complications within 30 days of surgery, according to data from the PRACTICROHN cohort.

“Analysis of the risk factors for early postoperative complications revealed that surgery performed at the time of diagnosis (probably an urgent surgery) and stricturing disease as the indication for surgery were both significantly associated in the bivariate analyses, with an increased risk of complications, and penetrating plus stricturing disease (more specifically, perforation) associated with a lower risk,” according to Ana Gutierrez, of Carlos III Health Institute, Madrid, Spain, and colleagues.

Their retrospective study included data on 364 patients from the PRACTICROHN cohort. These were adult patients with Crohn’s disease who underwent ileocolonic resection with ileocolonic anastomosis between January 2007 and December 2010.

The most common indication for surgery was stricturing disease (46.4%), with other indications including penetrating disease (31.3%), penetrating and structuring disease (14.0%) or resistance to medical treatment (5.8%).

Early complications – defined as those occurring within 30 days of surgery – occurred in 27.5% of patients. Wound infection (9.1%), intra-abdominal abscess (7.7%) and anastomotic leak (7.4%) were the most common early complications. The researchers said this rate of complications is in line with previous studies.

Patients without early complications had a significantly shorter hospital stay compared with those with early complications (9 vs. 16 days; P<.001).

Early complications were not linked with the surgical volume of each hospital, except for anastomotic leak, which occurred more commonly in hospitals with less than 30 surgeries performed during the study period than in hospitals with more than 60 surgeries (P=.001).

Patients with intestinal perforation as the indication for surgery had a higher rate of early complications (31.6%) and being refractory to treatment (42.9%) compared with patients with structuring disease (P=.040).

Gutierrez A, Rivero M, Martin-Arranz MD, et al. Gastroenterol Rep (Oxf). 2019;doi:10.1093/gastro/goz010.