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12 January 2022 : Clinical Research  

Retrospective Study of Surgical Outcomes in 60 Patients with Crohn Disease from a Single Center in Poland

Karolina Majewska1BCDEF*, Cezary Rusinowski1BCD, Beata Jabłońska ORCID logo2ACDE, Dariusz Gołka3E, Sławomir Mrowiec ORCID logo2AE

DOI: 10.12659/MSM.934463

Med Sci Monit 2022; 28:e934463

Abstract

BACKGROUND: In Crohn disease (CD), pharmacotherapy with nutritional support is the treatment of choice. However, complications and a lack of response to drugs are indications for surgery. The aim of this study was to present indications for surgery and methods of surgical treatment of CD and to analyze the postoperative morbidity and mortality risk factors.

MATERIAL AND METHODS: This was a retrospective analysis of adult patients who underwent surgery for CD between January 2015 and January 2019. Sixty of 457 patients (13%) hospitalized for CD required surgical treatment. The parameters age, sex, body mass index, duration, behavior and location of the disease, pharmacotherapy, indications for surgery, type and duration of surgery, perioperative complications, and laboratory tests results were analyzed.

RESULTS: Most procedures (90%) were elective. The most common indications for surgery were fistulae and strictures. The most frequently performed procedure was right hemicolectomy (60%). Thirty-two percent of patients had postoperative complications. Perianal disease (P=0.002) and penetrating behavior (P=0.01) were associated with more surgeries. Stricturing and penetrating behavior was more frequent in patients with ileal/ileocecal involvement than in those with CD affecting the colon (P=0.039). Patients with smoking history had a significantly lower age at first surgery (P=0.02). The use of anti-TNF medications appeared to extend time between diagnosis and first surgery (P=0.014).

CONCLUSIONS: Although the analysis did not reveal any risk factors for perioperative complications, perianal manifestations, penetrating disease type, ileal/ileocecal involvement, and smoking may be associated with risk of earlier surgery or multiple surgeries.

Keywords: Crohn Disease, general surgery, Postoperative Complications

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Dinah V. Parums
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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750