| Thiopurine therapy is associated with postoperative intra-abdominal septic complications in abdominal surgery for Crohn's disease. | |
| | |
MedLine Citation:
|
PMID: 19617749 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: Thiopurines are important as maintenance therapy in Crohn's disease, but there have been concerns whether thiopurines increase the risk for anastomotic complications. The present study was performed to assess whether thiopurines alone, or together with other possible risk factors, are associated with postoperative intra-abdominal septic complications after abdominal surgery for Crohn's disease. METHODS: Prospectively registered data regarding perioperative factors were collected at a single tertiary referral center from 1989 to 2002. Data from 343 consecutive abdominal operations on patients with Crohn's disease were entered into a multivariate analysis to evaluate risk factors for intra-abdominal septic complications. All operations involved either anastomoses, strictureplasties, or both; no operations, however, involved proximal diversion. RESULTS: Intra-abdominal septic complications occurred in 26 of 343 operations (8%). Thiopurine therapy was associated with an increased risk of intra-abdominal septic complications (16% with therapy; 6% without therapy; P = 0.044). Together with established risk factors such as preoperative intra-abdominal sepsis (18% with sepsis; 6% without sepsis; P = 0.024) and colo-colonic anastomosis (16% with such anastomosis; 6% with other types of anastomosis; P = 0.031), thiopurine therapy was associated with intra-abdominal septic complications in 24% if any 2 or all 3 risk factors were present compared with 13% if any 1 factor was present, and only 4% in patients if none of these factors were present (P < 0.0001). CONCLUSIONS: Thiopurine therapy is associated with postoperative intra-abdominal septic complications. The risk for intra-abdominal septic complications was related to the number of identified risk factors. This increased risk should be taken into consideration when planning surgery for Crohn's disease. |
| | |
Authors:
|
Pär Myrelid; Gunnar Olaison; Rune Sjödahl; Per-Olof Nyström; Sven Almer; Peter Andersson |
Related Documents
:
|
16920049 - Capsule endoscopy in patients with chronic abdominal pain. 21235299 - Functional and clinical outcomes following surgical treatment in patients with cervical... 23047389 - Factors influencing laparoscopic colorectal operative duration and its effect on clinic... 11878259 - Managing trauma patients with abdominal compartment syndrome. 16389099 - Elasticity of the living abdominal wall in laparoscopic surgery. 10798139 - Gastroschisis and omphalocele. 2626779 - Gastrointestinal manifestations of brucellosis in saudi arabian patients. 6393659 - Pancreatic pseudocyst. analysis of surgical therapy in 58 patients. 15972189 - The effect of a rotating night-float coverage scheme on preventable and potentially pre... |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Diseases of the colon and rectum Volume: 52 ISSN: 1530-0358 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2009 Aug |
Date Detail:
|
Created Date: 2009-07-20 Completed Date: 2009-08-06 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
|
Languages: eng Pagination: 1387-94 Citation Subset: IM |
Affiliation:
|
Department of Surgery, Unit of Colorectal Surgery, Linköping University Hospital, Linköping, Sweden. par.myrelid@lio.se |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Abdomen Adult Crohn Disease / surgery* Female Follow-Up Studies Humans Incidence Male Methyltransferases / therapeutic use* Middle Aged Prospective Studies Risk Factors Sepsis / drug therapy*, epidemiology Surgical Wound Infection / drug therapy*, epidemiology Survival Rate / trends Sweden / epidemiology Treatment Outcome Young Adult |
| Chemical | |
Reg. No./Substance:
|
EC 2.1.1.-/Methyltransferases; EC 2.1.1.67/thiopurine methyltransferase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Multivisceral resection for colon carcinoma.
Next Document: Does rectal mucosal blood flow affect the outcome of transanal advancement flap repair?