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2016 ; 8
(3
): 274-83
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Post-operative abdominal complications in Crohn s disease in the biological era:
Systematic review and meta-analysis
#MMPMID27022455
Waterland P
; Athanasiou T
; Patel H
World J Gastrointest Surg
2016[Mar]; 8
(3
): 274-83
PMID27022455
show ga
AIM: To perform a systematic review and meta-analysis on post-operative
complications after surgery for Crohn's disease (CD) comparing biological with no
therapy. METHODS: PubMed, Medline and Embase databases were searched to identify
studies comparing post-operative outcomes in CD patients receiving biological
therapy and those who did not. A meta-analysis with a random-effects model was
used to calculate pooled odds ratios (OR) and confidence intervals (CI) for each
outcome measure of interest. RESULTS: A total of 14 studies were included for
meta-analysis, comprising a total of 5425 patients with CD 1024 (biological
treatment, 4401 control group). After biological therapy there was an increased
risk of total infectious complications (OR = 1.52; 95%CI: 1.14-2.03, 8 studies)
and wound infection (OR = 1.73; 95%CI: 1.12-2.67; P = 0.01, 7 studies). There was
no increased risk for other complications including anastomotic leak (OR = 1.19;
95%CI: 0.82-1.71; P = 0.26), abdominal sepsis (OR = 1.22; 95%CI: 0.87-1.72; P =
0.25) and re-operation (OR = 1.12; 95%CI: 0.81-1.54; P = 0.46) in patients
receiving biological therapy. CONCLUSION: Pre-operative use of anti-TNF-? therapy
may increase risk of post-operative infectious complications after surgery for CD
and in particular wound related infections.
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