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Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 World+J+Gastrointest+Surg 2016 ; 8 (3): 274-83 Nephropedia Template TP
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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 PMID27022455show 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.