| Effect of perioperative immunosuppressive medication on early outcome in Crohn's disease patients. | |
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MedLine Citation:
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PMID: 19277774 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The aim of the present study was to examine the early outcome in patients undergoing intestinal resection for Crohn's disease (CD) while they are receiving perioperative immunosuppressive medication. METHODS: We reviewed patients with CD undergoing intestinal surgery from 1999 to 2007. Demographics and relevant perioperative information, including medication, were extracted from patient charts. Statistical analysis was performed using Fisher's exact test. RESULTS: During the course of the study period 112 with Crohn's disease underwent intestinal resection, and 69 of them were receiving perioperative medication (47, corticosteroids; 39, immunomodulators; and 17, anti-tumor necrosis factor-alpha antibodies). There were no deaths. Median blood loss was 137 ml. Twenty-two of the patients using perioperative medication (32%) experienced complications, 10 of which were major. The major complications occurred in 3 of the 43 patients (7%) who were not receiving perioperative medications, in 5 of 38 patients (13%) who were receiving one drug, 4 of 28 patients (14%) receiving two drugs, and 1 of 3 patients (33%) receiving three drugs. Thus the occurrence of major complications was not significantly greater in patients receiving perioperative medication. Risk factors for a major complication were intraoperative blood loss >400 ml (P < 0.003) and emergency surgery (P < 0.005). CONCLUSIONS: The occurrence of complications in Crohn's disease patients undergoing intestinal resection was not associated with the use of immunosuppressive medication. However, emergency surgery and blood loss were risk factors, and reflect the difficulty of surgery in this group of patients. |
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Authors:
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Adrian A Indar; Tonia M Young-Fadok; Jacques Heppell; Jonathan E Efron |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: World journal of surgery Volume: 33 ISSN: 0364-2313 ISO Abbreviation: World J Surg Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-04-21 Completed Date: 2009-06-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704052 Medline TA: World J Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1049-52 Citation Subset: IM |
Affiliation:
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Division of Colon and Rectal Surgery, Mayo Clinic Arizona, 5777 E. Mayo Blvd., Phoenix 85054, AZ 85054, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Cortex Hormones
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therapeutic use Adult Aged Aged, 80 and over Antibodies, Monoclonal / therapeutic use Combined Modality Therapy Crohn Disease / drug therapy, surgery* Digestive System Surgical Procedures / adverse effects* Drug Therapy, Combination Female Humans Immunologic Factors / therapeutic use Immunosuppressive Agents / therapeutic use* Male Middle Aged Perioperative Care / methods* Postoperative Complications Retrospective Studies Risk Factors Treatment Outcome Tumor Necrosis Factor-alpha / antagonists & inhibitors Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 0/Antibodies, Monoclonal; 0/Immunologic Factors; 0/Immunosuppressive Agents; 0/Tumor Necrosis Factor-alpha |
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