Document Detail


Risk factors for postoperative intra-abdominal septic complications after bowel resection in patients with Crohn's disease.
MedLine Citation:
PMID:  22874602     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Amane Kanazawa; Tetsuo Yamana; Kinya Okamoto; Rikisaburo Sahara
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  55     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-09     Completed Date:  2012-10-11     Revised Date:  2013-03-20    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  957-62     Citation Subset:  IM    
Affiliation:
Department of Coloproctology, Social Health Insurance Hospital, Hyakunincho, Shinjuku-ku, Tokyo, Japan. amanex2009@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Abdominal Abscess / 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:
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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