Return to theatre in Crohn's Disease in the biological era: F18


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Abstract

Aim:Biological therapy may increase the risk of postoperative complications in patients with Crohn's disease. This study aimed to examine trends in reoperation rates in Crohn's disease in the biological era.Method:Patients with Crohn's disease undergoing colorectal resection were identified from the Hospital Episode Statistics (HES) dataset between 2000 and 2008. Reoperation rates in 2000- 2005(timeA) were compared with those in 2006-2007(timeB). Reoperation was defined as reintervention for an intra-abdominal or wound complication during the index admission or upon readmission within 28 days of initial resection.Results:Between 2000 and 2008, 11 920 patients underwent colorectal resection. 7.6% (901/11920) required reoperation. The mean number of cases per year was 1483 in timeB and 1511 in timeA. The reoperation rate increased in the latter study period [timeA 7.2%(639/8898); timeB 8.7%(262/3022), P = 0.007]. In multiple regression analysis, patients in timeB were more likely to require reoperation [odds ratio 1.24 (CI 1.07-1.44), P = 0.005] than those in the earlier time period.Conclusion:Further research is required to assess whether the increased reoperation rates observed in the latter study period reflect an increase in surgical complications in the biological era or are as a result of worsening disease severity.

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