Preoperative infliximab therapy and postoperative complications afterproctocolectomy with ileum pouch anal anastomosis: OP20


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Abstract

Aim:To compare complication rates afterproctocolectomy with ileum pouch anal anastomosis (IPAA) in refractory ulcerative colitis patients with versus withoutpreoperative infliximab therapy.Method:Retrospectively, all pouchprocedures from 2006 until 2009 were assessed. Included were ulcerative colitis patients and therapy refractoriness; excluded were patients with other diagnoses or other surgical indications. Postoperative complications andpreoperative infliximab use were assessed.Results:Seventy-two patients were included; 33 underwent a 1-stageprocedure (proctocolectomy with IPAA) and 39 had a 2-stageprocedure (emergency colectomy and later completionproctectomy with IPAA). In the 1-stageprocedure patient characteristics were comparable. Of those, 21 patients hadpreoperative infliximab therapy. Total and infectious complications were not different. However more infliximab-treated patients had anastomotic leakage (4/21 vs 0/12; risk difference (RD) 19%; 95% CI: 2-36) and non-infectious complications (8/21 vs 1/12; RD 30%; 95% CI: 4-56). Although several patient characteristics in the 2-stage groups were not comparable, complication rates were similar in these 17 infliximab and 22 non-infliximab patients (total: 8/17 vs 8/22; RD 11%; 95% CI: -20-42).Conclusion:The data in this small study support a 2-stageprocedure in patients who have been on infliximab therapy

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