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Document type
články
články
Document record
Source: BMČ - články
Title
The Impact of Anti-Tumor Necrosis Factor Alpha Therapy on Postoperative Complications in Pediatric Crohn's Disease / V. Dotlacil, J. Bronsky, O. Hradsky, B. Frybova, S. Coufal, R. Skaba, M. Rygl,
Author
Dotlacil, Vojtech
Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic.

Bronsky, Jiri
Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic.

Hradsky, Ondrej
Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic.

Frybova, Barbora
Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic.

Coufal, Stepan
Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of The Czech Academy of Sciences, v.v.i. Prague, Czech Republic.

Skaba, Richard
Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic.

Rygl, Michal
Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic.

Cited source
European journal of pediatric surgery. 2020, roč. 30, č. 1, s. 27-32. ISSN: 0939-7248; 1439-359X (online).
Date of issue
2020
Language
angličtina
Country
Spojené státy americké
Document type
články
DOI
Pubmed ID
Link
Record number
bmc20028545
Persistent link
English Abstract
INTRODUCTION:  The incidence of Crohn's disease (CD) within the pediatric population is increasing worldwide. Despite a growing number of these patients receiving anti-tumor necrosis factor α therapy (anti-TNF-α), one-third of them still require surgery. There is limited data as to whether anti-TNF-α influences postoperative complications. We evaluated postoperative complications in patients who were or were not exposed to anti-TNF-α therapy in our institutional cohort. MATERIALS AND METHODS:  A retrospective review of CD patients who underwent abdominal surgery between September 2013 and September 2018 was performed. The patients were divided into two groups based on whether they were treated with anti-TNF-α within 90 days before surgery. Thirty-day postoperative complications were assessed using Clavien-Dindo classification (D-C); this examination included surgical site infections (SSIs), stoma complications, intra-abdominal septic complications, non-SSIs, bleeding, ileus, readmission rate, and return to the operating room. Mann-Whitney U-test, Fisher's exact test, and multivariate logistic regression analyses were used for statistical analysis. RESULTS:  Sixty-five patients (41 males) with a median age of 16 years (range: 7-19) at the time of operation were identified. The most common surgery was ileocecal resection in 49 (75%) patients. Forty-three (66.2%) patients were treated with anti-TNF-α preoperatively. Seven patients (11%) experienced postoperative complications. There was no statistically significant difference in postoperative complication in patients who did or did not receive anti-TNF-α before surgery (D-C minor 2.3% vs. 4.6%, p = 1; D-C major 7% vs. 9.1%, p = 1). CONCLUSION:  The use of anti-TNF-α in pediatric CD patients within the 90 days prior to their abdominal surgery was not associated with an increased risk of 30-day postoperative complications.
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