| Risk factors for postoperative intra-abdominal septic complications after bowel resection in patients with Crohn's disease. | |
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MedLine Citation:
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PMID: 22874602 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Postoperative intra-abdominal septic complications are a serious concern with regard to postoperative morbidity and mortality in Crohn's disease. OBJECTIVE: The aim of this study was to identify the clinical variables that potentially impact the risk of intra-abdominal septic complications in patients with Crohn's disease, as well al analyze the short-term prognosis in patients with postoperative intra-abdominal septic complications. DESIGN: This study is a retrospective review with the use of hospital medical records. SETTINGS: This investigation was conducted at a single-institution, tertiary referral center in Tokyo, Japan. PATIENTS: We reviewed 550 patients that had undergone 728 intestinal anastomoses during 633 operations for primary or recurrent Crohn's disease between January 2005 and December 2010. Postoperative intra-abdominal septic complications were defined as anastomotic leakage or intra-abdominal abscesses occurring within 1 month after surgery. MAIN OUTCOME MEASURE: Twenty-four clinical variables were evaluated as potential risk factors for postoperative intra-abdominal septic complications. These factors were analyzed by use of univariate and multivariate methods. RESULTS: Postoperative intra-abdominal septic complications occurred in 17 cases (2.7%), with no fatalities. Of the 17 patients, 13 had anastomotic leakage and 4 had intra-abdominal abscesses. In the univariate and multivariate analyses, penetrating type (p = 0.014), operation time >180 minutes (p = 0.004), and handsewn anastomoses (p = 0.005) were significantly independent risk factors for postoperative intra-abdominal septic complications. Patients experiencing intra-abdominal septic complications had significantly higher 1-year reoperation rates (41.2%) than patients without intra-abdominal septic complications (2.3%, p < 0.0001). LIMITATIONS: This study was limited by being a retrospective review, and the details regarding postoperative complications other than intra-abdominal septic complications were not completely available. CONCLUSIONS: Penetrating type, operation time >180 minutes, and handsewn anastomoses significantly increased the risk of postoperative intra-abdominal septic complications in Crohn's disease. Postoperative intra-abdominal septic complications had a negative influence on the short-term outcome in Crohn's disease. |
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Authors:
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Amane Kanazawa; Tetsuo Yamana; Kinya Okamoto; Rikisaburo Sahara |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 55 ISSN: 1530-0358 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-08-09 Completed Date: 2012-10-11 Revised Date: 2013-03-20 |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
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Languages: eng Pagination: 957-62 Citation Subset: IM |
Affiliation:
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Department of Coloproctology, Social Health Insurance Hospital, Hyakunincho, Shinjuku-ku, Tokyo, Japan. amanex2009@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Abscess
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etiology Adolescent Adult Aged Anastomosis, Surgical / adverse effects Anastomotic Leak / etiology Crohn Disease / complications, surgery* Digestive System Surgical Procedures / adverse effects* Female Humans Intestinal Fistula / etiology Intestines / surgery* Male Middle Aged Prognosis Risk Factors Sepsis Young Adult |
| Comments/Corrections | |
Comment In:
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Dis Colon Rectum. 2013 Mar;56(3):e33-4
[PMID:
23392161
]
Dis Colon Rectum. 2013 Mar;56(3):e33 [PMID: 23392160 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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