Iesalnieks, Igors and Kilger, Alexandra and Glass, Heidi and Obermeier, Florian and Agha, Ayman and Schlitt, Hans J. (2010) Perforating Crohn's Ileitis: Delay of Surgery Is Associated with Inferior Postoperative Outcome. INFLAMMATORY BOWEL DISEASES, 16 (12). pp. 2125-2130. ISSN 1078-0998,
Full text not available from this repository. (Request a copy)Abstract
Background: A perforating phenotype is associated with an increased postoperative morbidity in patients with Crohn's disease undergoing ileocolic resection. Sequential conservative treatment attempts applied to patients with unrecognized perforating complications may lead to a delay of surgery and a further increase in morbidity. Methods: In all, 197 patients underwent 231 bowel resections for perforating ileitis between 1992 and 2009. The duration or clinical deterioration was calculated from the onset of clinical exacerbation unresponsive to any medical treatment to the date of surgery. Results: The median duration of clinical deterioration leading to surgery was 5 months. Patients with preoperative exacerbation lasting for > 5 months had a higher number of structures involved in the inflammatory mass (3.3 versus 2.8 structures, P = 0.013), and had a higher probability to take immunosuppressive drugs (26% versus 14%, P = 0.042), budesonide (29% versus 14%, P = 0.009), and a multiple-drug combination (31% versus 16%, P = 0.015) at the time of surgery. Patients with symptoms lasting > 5 months prior to surgery had a higher incidence of postoperative septic complications (31% versus 13%, P = 0.002), both by univariate and multivariate analysis. There was a significant increase in duration of preoperative clinical deterioration, size of the inflammatory mass, incidence of preoperative weight loss, intake of immunosuppressants and multiple-drug combination, and postoperative morbidity during the last :5 years of the study. Conclusions: Delay of surgery in patients presenting with symptoms attributable to perforating ileitis is associated with an increased postoperative risk.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INTRAABDOMINAL SEPTIC COMPLICATIONS; INFLAMMATORY-BOWEL-DISEASE; RISK-FACTORS; STAPLED ANASTOMOSIS; ILEOCECAL RESECTION; MANAGEMENT; perforating ileitis; postoperative risk; Crohn's disease |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Jul 2020 07:43 |
| Last Modified: | 06 Jul 2020 07:43 |
| URI: | https://pred.uni-regensburg.de/id/eprint/23795 |
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